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Article
Analytical Study of Medical Image Combination Techniques

Authors: Heba Kh. Abbas --- Anwar H. Mahdy --- Ali A. Al Zuky --- Sally F. Ahmad
Journal: Iraqi Journal of Science المجلة العراقية للعلوم ISSN: 00672904/23121637 Year: 2018 Volume: 59 Issue: 3B Pages: 1538-1547
Publisher: Baghdad University جامعة بغداد

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Abstract

Image combination is a technique that fuses two or more medical images taken with different conditions or imaging devices into a single image contain complete information. In this study relied on mathematical, statistical and spatial techniques, to fuse MRI images that captured horizontal and vertical times (T1, T2), and applied a method of supervised classification based on the minimum distance before and after combination process, then examine the quality of the resulting image based on the statistical standards resulting from the analysis of edge analysis, showing the results to identify the best techniques adopted in combination process, determine the exact details in each class and between classes.

Keywords

combination --- MRI --- contrast


Article
Optimization of Effluent Phosphorus Control For Al-Aziziah (Wasit) Wastewater Treatment Plant

Author: Mohammed Siwan Shamkhi محمد صيوان شمخي
Journal: Wasit Journal of Engineering Sciences مجلة واسط للعلوم الهندسية ISSN: 23056932 Year: 2015 Volume: 3 Issue: 1 Pages: 1-8
Publisher: Wassit University جامعة واسط

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Abstract

The combination between the enhance biological phosphorus removal EBPR process and chemical phosphorous precipitation process removal from wastewater to avoid the instability of the biological phosphorus removal process due to temperature variation has been simulated and optimized by implementing three different strategies in the GPS-X 5.0 modeling and simulation software (Hydro mantis). The results were demonstrated that the annual consumption of alum for the three different phosphorus control strategies (side stream line dosing only, wastewater line dosing only and dosing at both wastewater and side stream lines) were 290, 80 and 68 tons Alum/year respectively. Therefore, the implement of both wastewater and side stream lines dosing strategy show a better phosphorus removal choice in terms of effluent quality and amount of alum used

الاستخدام المزدوج لعملية المعالجة البيولوجية والترسيب الكيميائي لإزالة مركبات الفسفور من مياه المجاري لتفادي عدم الأستقرارية في طريقة المعالجة البيولوجية بسبب تغير درجات الحرارة تم نمذجتها باستخدام البرنامج GPS-X 5.0 على ثلاثة مقترحات من عمليات الدمج بين طرق الإزالة البيولوجية والكيميائية لاختيار أفضل المقترحات. أظهرت النتائج بأن الاستهلاك السنوي للشب المستخدم للسيطرة على تركيز مركبات الفسفور في المياه المعالجة باستخدام مقترحات المعالجة الثلاثة ( أضافة الشب لخط المياه الراجعة فقط ، أضافة الشب الى خط المياه المعالجة فقط، أضافة الشب الى خط المياه الراجعة والمياه المعالجة) هو 290 ، 80 ، 68 طن سنويا على التوالي. لذلك فأن أضافة الشب الى خط المياه الراجعة والمياه المعالجة يعتبر أفضل الحلول لإزالة مركبات الفسفور من ناحية نوعية المياه المعالجة ومن ناحية كمية الشب المستخدم


Article
Combination Therapy with Hydroquinone, Tretinoin and Steroid for Treatment of Melasma in Iraqi patients

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Abstract

Background: Melasma is one of the most frequently acquired hyperpigmentation disorders clinically characterized by symmetrical brown patches on sun exposed areas. The pathogenesis of melasma is not fully understood, but several hypotheses have been suggested. Patient treatment is particularly difficult and challenging, and necessitates using different modalities of treatment which is a burden on the patient.Objectives: The aim of this study was to evaluate the efficacy of combination of retinoic acid, steroids and hydroquinone in reducing melasma.Patients and Methods: The study was conducted at the private clinic, Kerbala city in the period July 2008- March 2009. One hundred & thirteen patients with melasma were included in this study, all of them were female (pregnant and nursing mothers were excluded), with an age range 25-40 years. Full clinical examination was done for all patients ,the severity of melasma was assessed by the melasma area severity index(MASI).The treatment include using of combination of retinoic acid 0.25,steroid (hydrocortisone cream ,Betamethasone cream and clobetasol propionate cream ) and hydroquinone in addition to use of sunblock SPF60 regularly for all patients .The patients divided in to three groups according to primary cause of melasma and the treatment modules were as follow:Group 1: (sun exposure ) the formula used was retinoic acid 0.25 ,hydroquinone 2% and hydrocortisone cream ,for group (2)(cosmetic ) the formula used was retinoic acid cream 0.25 ,hydroquinone cream 4%and betamethasone cream and for group (3) (pregnancy cause )we used retinoic acid cream 0.25 ,hydroquinone cream 4% and clobetasol propionate cream .The follow up and response to treatment recorded every week depending on the MASI until the desired response was achieved at the end of 4th week .follow-up was carried out for 6 months later to record any relapse.Result: The results revealed marked improvement and significant decrease in MASI in all groups .The MASI for group (1) decrease from 10.6 to reach 3.18,MASI for group (2) was decreased from 15.5 to 3.88 while MASI for group (3) decreased from 22 to reach 4.4 .No side or unwanted effect recorded or informed by the patients .Conclusion: Combination of retinoic acid, steroids and hydroquinone was found to be effective in reducing and treating melasma if used in proper way.

الكلف هو واحد من الامراض الشائعة, يتميز سريريا ببقع متناضره سمراء اللون تغطي الوجه وخاصة المناطق المعرضه للشمس .فيما يخص اسباب المرض لحد الان هي غير مفهومه بشكل كامل وهنالك عدة فرضيات تحاول تفسيره. علاج الكلف يعتبر من الامور الصعبة والتي تحتاج عدد كبير من الادويه المختلفة وهذا يكلف المريض الوقت والمال.الاهداف: الهدف من هذه الدراسه هو تقييم فعالية المركب المكون من حامض الرتنويك والاسترويد والهايدروكونون.المرضى والمنهج :تمت الدرسة في عيادة خاصة في مدينة كربلاء للفتره من تموز 2008 ولغاية اذار 2009.شارك في الدراسة مائة وثلاثة عشر مريضا وجميعهم كانوا اناثا , ولقد تم اقصاء الحوامل والمرضعات.كانت اعمار المرضى تتراوح ما بين 25 و40 سنه.(MASIتم فحص المرضى بشكل سريري وتم تحديد درجة الاصابه حسب نظام خاص يعرف ب ( تم تقسيم المرضى الى ثلاثة مجاميع حسب السبب الرئيسي للمرض الى:1-مجموعة (التعرض للشمس): تم استخدام حامض الرتنويك 0.25 ,هايدروكونون 2% وهايدروكورتزون كريم.2-مجموعة(المواد التجميلية): استخدمت حامض الرتنويك 0.25 ,هايدروكونون 4% وبيتاميثازون كريم.3-مجموعة(الحمل): استخدمت : حامض الرتنويك 0.25 ,هايدروكونون 4% كلوبيتازول بروبيونيت كريم.تم متابعة المرضى كل اسبوعان ولمدة ستة اشهرلتسجيل اي انتكاسه للمرض من جديد.النتائج:لقد تم تسجيل تحسن ملحوض في شدة المرض في كل المجاميع بنسب مختلفة حسب النظام المذكور.الاستنتاج:ان المركب المكون من حامض الرتنويك والستيرويد والهايدروكونون وجد انه فعال في تقليل الكلف وعلاجه اذا تم استخدامه بشكل مناسب لكل حالة.


Article
The Effect of Tamsulosin and Combination of Terpenes (Rowatinex) on the Clearance of Renal Stone Gravels After Single Session of Extracorporeal Shock Wave Lithotripsy (ESWL)

Author: Waleed Nassar Jaffal وليد نصار جفال
Journal: Al- Anbar Medical Journal مجلة الأنبار الطبية ISSN: PISSN: 27066207 / EISSN: 26643154 Year: 2012 Volume: 10 Issue: 2 Pages: 26-33
Publisher: University of Anbar جامعة الانبار

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Abstract

Background: Extracorporeal shock wave lithotripsy (ESWL) is currently considered one of the main lines of treatments for urolithiasis. The effectiveness of pharmacologic therapies in facilitating stones expulsion after ESWL has been reported.Objectives: To evaluate the effect of Tamsulosin and terpenes combination (Rowatinex) on the clearance of stone gravels after extracorporeal shock wave lithotripsy (ESWL) of renal stone.Methods: From May 2010 to June 2011 (84) patients with single radio opaque renal stone presented to urologic consultation department at Al-Ramadi teaching hospital/Iraq were included in this prospective, case-control study. All patients were examined by ultrasonography, and intravenous urography. Their age ranged from 19 to 62 years. All patients underwent ESWL and randomly divided into three groups, group A, of 28 patients, received conservative medical therapy alone and served as the control group, group B, of 28 patients, received tamsulosin 0.4 mg once daily in addition to conservative medical treatment and group C, of 28 patients, received Rowatinex capsules, 1 capsule before food 3 times daily in addition to conservative medical therapy. All patients were followed up by clinical examination, urine analysis, ulrasonography and abdominal radiograph (KUB) at 4 and 8 weeks and the number of patients with clinical success was recorded. Clinical success defined as stone-free status or clinically insignificant stone. Results: The age of patients ranged from 19 to 60 years in group A (mean 35.7±6), 20-62 years in group B (mean 36.6±13.25) and 20-61 years in group C (mean 36.2±13.02), there was no significant statistical difference between the age, gender and site and size of renal stones among the three groups (p value > 0.05). The percentage of patients with clinical success after ESWL at 4 weeks was 23% in group A, 44% in group B and 40% in group C and increased to 46%, 80% and 76% in group A, B and C respectively at 8 weeks. The clinical success was statistically more significant in group B and C compared to group A at both 4 and 8 weeks ( p value < 0.05). There was no statistically significant difference in the clinical success between group B and C (p value > 0.05). Although the incidence of drugs side effects in group B and C occurred more than in group A, but no significant side-effect was detected so as to require exclusion of a patient from the study and medical intervention was not performed in any of the patients because of side-effects.Conclusion: The use of medical expulsion in this study by tamsulosin or terpenes combination (Rowatinex) was well tolerated and it demonstrated that it is clinically meaningful and statistically it has significant improvement in the clearance of stone fragments after ESWL of renal stone. The effect on tamsulosin and terpenes combination (Rowatinex) is comparable.


Article
Determination of Paracetamol and Tramadol Hydrochloride in Pharmaceutical Preparations Using Green UV Method
تقدير الباراسيتامول وهيدروكلوريد الترامادول في مستحضراتهما الصيدلانية بطريقة خضراء طيفية

Authors: Hana Sh. Mahmood هناء شكر محمود --- Nagham T. Dawood نغم طه داؤد
Journal: Rafidain journal of science مجلة علوم الرافدين ISSN: 16089391 Year: 2018 Volume: 27 Issue: 1E Pages: 36-42
Publisher: Mosul University جامعة الموصل

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Abstract

A simple, precise, and friendly environmental method for the determination of paracetamol and tramadol hydrochloride in pharmaceutical preparations has been worked out. The method is based on the determination of paracetamol at 242 nm and replaces its concentration in a multicomponent system equation for determination of both paracetamol and tramadol at 227 nm. Beer's law for paracetamol was obeyed over the concentration range 8-25 ppm at 242 nm and 4-16 ppm at 227 nm ,for tramadol it is obeyed over the range 2-14 ppm at 227 nm, water is used as a solvent for dissolution. The method is applicable to the determination of paracetamol and tramadol in their pharmaceutical preparations without prior separation steps from excipients as well as for determination of paracetamol in the presence of tramadol. The average recoveries for determination of mentioned drugs were 94.20-100.14%, and the average relative standard deviation of the method was better than ± 0.646%.

تم تقدير الباراسيتامول وهيدروكلوريد الترامادول في مستحضراتهما الصيدلانية بطريقة طيفية باستخدام طريقة مأمونة وسهلة وذات مضبوطية عالية. تعتمد الطريقة على إذابة المستحضر في الماء وتقدير الباراسيتامول عند طول موجي 242 نانوميتر ثم ايجاد تركيز الترامادول عند طول موجي 227 نانوميتر باستخدام معادلة الامتصاص لنموذج متعدد المكونات. اظهر الباراسيتامول خضوعا لقانون بيير لمدى من التراكيز25-8 جزء/ مليون عند الطول الموجي 242 نانوميتر ولمدى 16- 4 جزء / مليون عند الطول الموجي227 نانوميتر في حين اظهر الترامادول خضوعاً لقانون بيير لمدى من التراكيز 14-2 جزء / مليون عند الطول الموجي 227 نانوميتر. اظهرت الطريقة قابلية تطبيق للادوية المذكورة في مستحضراتهما الصيدلانيـة وكذلك تقديـر الباراسـيتامول بوجود الترامادول. كان معدل نسبة الاسترجاع لتقدير الأدوية المذكورة %100.14 -94.20 وكان معدل الانحراف القياسي النسبي للطريقة أفضل من ± 0.646%.


Article
EFFECT OF TOW COMBINATION SPRAYING BY IRON AND MANGANES SULFATE ON GROWTH TRAITS OF THREE SOYBEAN CULTIVARS
تأثير الرش بتوليفتين من كبريتات الحديدوز والمنغنيز في صفات النمو الخضري لثلاثة اصناف من فول الصويا

Authors: Ismael A. Serhan اسماعيل احمد سرحان --- Naeem A. Mutlag نعيم عبدالله مطلك --- Sami N. Al- Saadoon سامي نوري السعدون
Journal: ANBAR JOURNAL OF AGRICULTURAL SCIENCES مجلة الأنبار للعلوم الزراعية ISSN: PISSN: 19927479 / EISSN: 26176211 Year: 2011 Volume: 9 Issue: 3 Pages: 203-214
Publisher: University of Anbar جامعة الانبار

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Abstract

A field experiment was conducted in a loamy sand texture soil during summer season of 2009 . In the falluja City of Al – Anbar Governorate to study the effect of spraying three levels of Iron and Manganese sulfate mixed together ( 0 , 50+50 and100+100) mg/L in growth traits of three soybean cultivars ( LS 74 , Jeza 22 and Jeza 83 ) A factorial experiment arrangement in randomaized complete block design ( R.C.B.D.) with three replicates . The most important result were: Soybean cultivars showed a different significant in all traits except the number of tellers /plant . The cultivar LS74 gave a highest average in : plant height , number of nods in the stem , leaf area ,leaf area index and highest of first pod . While the cultivar Jeza 83 gave a lower rate in number of days from planting to flowering and number of days from planting to maturity.The spraying of Iron and Manganese showed that a significant effect for all traits except the highest of first pod from the soil . Spraying the level (50+50 ) mg/L gave a highest rate in : plant height ,number of nods / stem ,number of tellers / plant , leaf area , leaf area index and lower number of days from planting to flowering .while spraying the level ( 100+100 ) mg/L gave a lower rate in number of days from planting to matur only .The interaction between cultivars and spraying Iron and Manganese was significant effect in leaf area index and number of days from planting to maturity . But this interaction was not significant in other traits .

نفذت تجربة حقلية في تربة ذات نسجة مزيجة رملية خلال الموسم الصيفي لعام 2009 في حقول احد المزارعين في الفلوجة – محافظة الانبار . لمعرفة تأثير رش توليفتين من الحديد والمنغنيز اضافة للمقارنة ( 0 و 50 +50 و 100 + 100 ) ملغم . لتر-1 في صفات النمو الخضري لثلاثة اصناف من فول الصويا ( Lee74 و جيزة 22 وجيزة 83 ) . طبقت تجربة عاملية حسب تصميم القطاعات الكاملة المعشاة R.C.B.D. وبثلاثة مكررات . وكانت اهم النتائج ما يلي :•اختلفت الاصناف معنويا فيما بينها في جميع مؤشرات الدراسة باستثناء عدد الافرع /نبات . اعطى الصنف LS74 اعلى معدل لكل من ارتفاع النبات و عدد العقد على الساق و المساحة الورقية و دليل المساحة الورقية وارتفاع اول قرنة .بينما اعطى الصنف جيزة 83 اقل مدة لعدد الايام من الزراعةالى التزهير واقل مدة لعدد الايام من الزراعة الى النضج . •اثرت توليفات الحديد والمنغنيز رشا على الاوراق تأثيرا معنويا في جميع مؤشرات الدراسة بأستثناء ارتفاع اول قرنة عن سطح التربة . اذ اعطت اضافة هذه المغذيات بالتوليفه ( 50 + 50 ) ملغم . لتر-1 اعلى معدل لكل من ارتفاع النبات و عدد العقد على الساق و عدد الافرع بالنبات و المساحة الورقية و دليل المساحة الورقية واقل مدة لعدد الايام من الزراعة الى التزهير . بينما اعطت التوليفة (100 + 100 ) ملغم . لتر-1 اقل مدة لعدد الايام من الزراعة الى النضج فقط .•اثر التداخل بين الاصناف ومستويات اضافة الحديد والمنغنيز تأثيرا معنويا في دليل المساحة الورقية وعدد الايام من الزراعة الى النضج . غير انها لم تؤثر في بقية الصفات الاخرى .


Article
Effect of changing packing shapes on the evaporation rates using different combination arrangements of dry-wet cooling towers

Author: Nagam Obaid Kariem
Journal: Al-Qadisiyah Journal for Engineering Sciences مجلة القادسية للعلوم الهندسية ISSN: 19984456 Year: 2013 Volume: 6 Issue: 2 Pages: 232-246
Publisher: Al-Qadisiyah University جامعة القادسية

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Abstract

The aim of this study is reduce the evaporation rate from dry-wet cooling tower combination system through using different shapes and different arrangements between dry and wet cooling towers. Four shapes of corrugated packing were used in the study with all arrangements combination between dry and wet cooling towers in order to get the shape that give minimum evaporation rate (loss). Four arrangements combination of dry-wet cooling tower, two of arrangement were series (AS1, and AS2), and two of arrangements were parallel (AP1, andAP2). The variables for this study were obtained from North Oil Company (N.O.C.) in the Ministry of Oil of Iraq; these data included temperatures, flow rate, packing types, ambient conditions, pressure, and fan parameters. The results show that AS1 configuration produces lower evaporation rates by about 58 % reducing in percent, and then followed by the other configuration. The corrugated types 1 and 4 gives the minimum amount of evaporation losses then the other types of corrugated by about 40 %. The corrugated types 1 and 4 operated with a minimum cost of operation

الغرض من البحث تقليل معدل التبخر من منظومة ابراج التبريد الجافة-الرطبة و ذلك من خلال استعمال اشكال مختلفة من الحشوات المتموجة و كذلك من خلال الربط المختلف بين ابراج التبريد الجافة-الرطبة. تم استعمال اربعة اشكال مختلفة من الحشوات المتموجة لهذه الدراسة مع مختلف انواع الربط بين ابراج التبريد الجافة و الرطبة وذلك لغرض الحصول على الشكل المتموج الذي يعطي اقل معدل تبخير(فقدان). تضمن الربط بين الابراج الجافة و الرطبة ,ربطين على التوالي (AS1,AS2) و ربطين على التوازي (AP1,AP2). المتغيرات لهذه الدراسة بمعطيات من شركة نفط الجنوب العائدة لوزارة النفط العراقية و شملت هذه المتغيرات كل من الحرارة و نعدل الجريان و شكل الحشوات و الظروف الجوية والضغط و معاملات المروحة. بينت النتائج ان الربط AS1 ينتج اقل معدل فقدان تبخيرمن ابراج التبريد و ذلك بمعدل 40% و ثم يليه باقي انواع الربط الاخرى.بينت النتائج ان الاشكال المتموجة رقم 1 و رقم 4 تعطي اقل معدلات فقدان تبخير بمقدار 40% عن باقي انواع الاخرى من الاشكال المتموجة,كذلك لوحظ ان الشكلين المتموجين 1 و 4 يعملان باقل كلفة تشغلية للابراج .

Keywords

Cooling --- wet --- dry --- corrugated --- evaporation rate --- and combination


Article
A New Subclass of Harmonic Univalent Functions
صنف جزئي جديد من الدوال أحادية التكافؤ التوافقية

Authors: Najah Ali Jiben Al-Ziadi نجاح علي جبن --- Waggas Galib Atshan وقاص غالب عطشان
Journal: Journal of Al-Qadisiyah for Computer Science and Mathematics مجلة القادسية لعلوم الحاسوب والرياضيات ISSN: 20740204 / 25213504 Year: 2017 Volume: 9 Issue: 2 Pages: 26-32 Math
Publisher: Al-Qadisiyah University جامعة القادسية

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Abstract

In this paper, we define a new class of harmonic univalent functions of the form f=h+¯g in the open unit disk U. We obtain basic properties, like, coefficient bounds, extreme points, convex combination, distortion and growth theorems and integral operator.

في هذا البحث, عرفنا صنف جديد من الدوال أحادية التكافؤ التوافقية من الشكل f=h+¯g في قرص الوحدة المفتوح U. حصلنا على الخواص الأساسية مثل, حدود المعامل, نقاط متطرفة, التركيب المحدب, مبرهنات النمو والتشوية ومؤثر تكاملي.


Article
The Study of Oral Findings, Oxidative Stress and Antioxidant Vitamin E in Serum and Saliva of Crohn's Patients on Azathioprine Monotherapy and those on Combination of Anti-TNF-α Plus Azathioprine

Authors: Zainab Kh. Abbas --- Taghreed F. Zaidan
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2018 Volume: 30 Issue: 1 Pages: 39-45
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Crohn's disease (CD) is an immunological disorder associated with chronic inflammatory process of several unspecific regions of gastrointestinal tract but frequently detected in the terminal Ilium and proximal colon or both. This disease frequently presented with various oral manifestations as a consequence of inflammatory process of the disease, nutritional deficiency or medications side effects. Several therapeutic approaches have been developed for CD management that are targeting the inflammatory process and directed at controlling the host immune response. Immunosuppressants such as Azathioprine and anti-TNF α agents as well as the combination of them have been widely used as an effective therapeutic modality with a better chance of achieving clinical remission and decrease the risk of future complications.Subjects, Materials, and Methods: Seventy-five subjects were incorporated in this study; fifty subjects presented with moderate to severe CD that were subdivided into two subgroups treated with different therapeutic modalities( Azathioprine monotherapy and Combination of anti TNF-α biological agent (Infliximab) plus Azathioprine), while other twenty-five were age and gender matched healthy control subjects. Body mass index (BMI) of all participants was determined by weight (kg) high (m2). Oral cavity of each patient was examined for the presence of oral manifestations. Blood and saliva samples were gained from each subject enrolled in this study and salivary flow rate (mlmin) was measured for those participants, then these samples were centrifuged and the supernatants frizzed for subsequent oxidative stress and antioxidants biomarkers assessment.Results: The means of BMI and salivary flow rate were significantly higher in combination treated group than Azathioprine treated group. Fungal infection was the main oral findings that observed among Crohn's patients on combination therapy compared with those on Azathioprine monotherapy. Assessment of oxidative stress and antioxidant activity revealed that the means of serum and saliva Malondialdehyde (MDA) were highly significantly higher in Azathioprine treated group than combination treated group, while Vitamin E (VE) level showed significant reduction in Azathioprine Crohn's group as compared to combination treated group. Significant negative linear correlation was found between MDA level in serum and saliva with duration of treatment, while highly significant positive correlation was detected between VE levels and duration of treatment.Conclusions: Oxidative stress was increased with reduced antioxidant level in both groups of Crohn's patients. Treatment with Combination therapy approved to be effective in controlling oxidative tissue damage and enhanced antioxidants system in Crohn's patients better than Azathioprine monotherapy. Fungal infection was the most predominant oral manifestations among Crohn's patients on combination therapy as a result of concomitant immunosuppressive effect that accounted for reduced immune response to opportunistic infections


Article
Establishing the Superiority of Topical Diltiazem Over Compound Cream in the Treatment of Chronic Anal Fissure: A Prospective Analytical Study

Author: Ahmed Nasser Hussein, Maytham Hatam Shahid, Abd Alkhaliq S Abdullah
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2017 Volume: 16 Issue: 4 Pages: 434-437
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Anal fissure is an elliptical ulcer in the anal canal extending from the dentate line to the anal verge; chronic anal fissure is a common problem across the world treated largely by surgical methods. The treatment for chronic anal fissure (CAF) has undergone a transformation in recent years from surgical to medical as the common goal is reducing the internal anal sphincter spasm.OBJECTIVE:To assess the efficacy of topical treatment with 2% diltiazem gel (DTZ) in patient with chronic anal fissure versus combination cream.MATERIAL AND METHODS:Consecutive 400 adult male patients with symptomatic chronic anal fissure attending the surgery clinic were enrolled in the study form February 2014- July 2016, 200 patients were treated with topical application of 2% DTZ cream, other 200 patients were treated with combination cream. Patients were followed up for 6 month at regular intervals for symptomatic relief and healing of fissure.RESULT &CONCLUSION:In our study diltiazem 2% gel was more effective than combination cream in the treatment of chronic anal fissure..

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