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Article
CHARACTERISTICS AND CLINICAL MANAGEMENT OF FEMALE PATIENTS WITH FISSURE IN ANO IN AL-KADHIMIYA CITY, BAGHDAD

Author: Qahtan A. Mahdi قحطان عدنان مهدي
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2013 Volume: 11 Issue: 3 Pages: 238-242
Publisher: Al-Nahrain University جامعة النهرين

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Background:Fissure in ano is a common painful anal problem in female patients.Objective:To study the sociodemographic variables of female patients with fissure in ano, and to identified the characteristic of anal fissure and their treatment among those patient in Al-Imamian Al-Kadhimiyian Medical City and two private hospitals.Methods:This is a prospective study that was carried out from May 2008 to May 2011. Two hundred fifty female patients with fissure in ano were interviewed regarding their age, marital state, address, level of education, clinical presentation and the subsequent management.Result:The commonest age of presentation in females was between 21-30 years. 78% of them were living at the peripheral areas of north of Baghdad, and 79.6% were of low level of education (primary school or below). The prevalence was found more in women with high parity especially when their child delivery was supervised by a midwife in their location. All patient has presented with anal pain, 55% were associated with bleeding per rectum and 64.2% with constipation. The location of fissures was 51.6% anterior, 48% posterior, 0.4% lateral in position. Less than half of patients underwent a surgical treatment. 77% of them were treated by lord dilatation under anesthesia and 23% by lateral sphinecteromty.Conclusion:Factors which had an impact on the clinical course and management of fissure in ano in female patients were found to be the social status, the level of education and the parity, therefore to prevent this illness, a cooperation between the heath services and the family health center and the government is necessary in order to overcome such a common problem.Keywords:Fissure in ano, Female

Keywords

Fissure in ano --- Female


Article
Anal Fissure among Female in Erbil City
الشق الشرجي عند الإناث في مدينة أربيل

Author: Bahjat Ahmed Mohammad
Journal: kufa Journal for Nursing sciences مجلة الكوفة لعلوم التمريض ISSN: 22234055 Year: 2013 Volume: 3 Issue: 3 Pages: 21-25
Publisher: University of Kufa جامعة الكوفة

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Objectives: to identify the causes of the fissure in ano among child bearing age female in Erbil city because it is very common in the Kurdistan.Methods :- This prospective study of evaluation of fissure in ano among female patients in Erbil city and its surrounding for the period between may 2010 and may 2012, Data collected from 500 cases showed that fissure in ano is most common cause of ano-rectal pain in this locality among child bearing age females from clinic ,Erbil teaching hospital and Erbil gynecological hospital All the patients were interviewed and clinical data were recorded including; age, occupation, marital state, number of children, types of fissure in ano, sites of fissure, associated symptoms, its treatment and recurrence. Period from first onset of symptoms to first medical consultation were recorded and showed that most of them were delayed.Results: from 500 cases showed that fissure in ano is most common cause of ano-rectal pain in this locality among child bearing age females from clinic ,Erbil teaching hospital and Erbil gynecological hospital.Conclusion: the fissure in ano is the most common disease among female childbearing age and usually due to bad post natal careRecommendation: for prevention of this painful condition I advice the gynaecologist and obstetrician to do peri anal care.

الأهداف: هذه دراسة وصفية أجريت لتقييم حالات الفطر الشرجي بين النساء في مدينة اربيل و ضواحيها, الفطر الشرجي هو مشكلة شائعة بين النساء اكثر مما هو في الرجال, وهو تقرح خطي في النصف الأسفل من القنات الشرجية الواقعة في الجدار الخلفي والوسطي.المنهجية: جمعت المعلومات من 500 حالة للفترة الممتدة من ايار 2010- الى ايار 2012 من خمسمائة مريض اجروا مقابلة والفحص السريري وتم تسجيل المعلومات السريرية وكانت تتضمن العمر , محل الإقامة, الوظيفة, الحالة الاجتماعية, عدد الأطفال نوع وموقع فطر الشرجي وكذلك الأعراض المصاحبة والعلاج ورجوع الفطر بعد العلاج مرة أخرى. بالإضافة الى ذلك تم احتساب الفترة الزمنية بين ظهور أول عرض للمرض ومراجعة المريضة للطبيب لغرض العلاج. النتائج: الفطر الشرجي حالة متكررة بين النساء القادرات على الحمل وأظهرت النتائج من مجموع الحالات 76.8% منهم كانوا متزوجات و23.3% كانوا غير متزوجات.الاستنتاج: عدد الأطفال ومكان الولادة والعوامل الاجتماعية والتعليمية هي من العوامل المشاركة في تطور المرض.التوصيات: يجب زيادة التوعية الاجتماعية لهذه المشاكل ومضاعفاتها.

Keywords

fissure --- ano --- female.


Article
Microleakage of Pit and Fissure Sealants after Using Different Occlusal Surface Preparation Techniques: An In Vitro Study

Author: Nibal Mohammed Hoobi نبال محمد هوبي
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2016 Volume: 28 Issue: 3 Pages: 172-177
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: The marginal seal is essential for sealant success because penetration of bacteria under the sealantmight allow caries onset or progression. The aim of the present study was to estimate and compare themicroleakage of pit and fissure sealant after various methods of occlusal surface preparation.Materials and methods: Thirty non-carious premolars extracted for orthodontic reasons were equally divided intothree groups. In group one, occlusal fissures were opened with round carbide bur, in group two, occlusal surfaces ofthe teeth were cleaned with a dry pointed bristle brush and samples of group three were cleaned with a slurry of fineflour of pumice in water using rubber cup. Then fissures of all teeth were etched using 35% phosphoric acid gel priorto placement of Conseal F (SDI) light cured sealant, the teeth were thermocycled, then they were immersed in 1%methylene blue for 24hours. Each tooth was sectioned bucco-lingually to detect the microleakage.Results: Different levels of microleakage were observed among various groups, highest level was recorded forbrushing group followed by pumice group, while round bur samples showed the least microleakage whencompared with other groups. Statistically the difference was not significant between brushing and pumice groups,while it was significant between round bur and other groupsConclusion: Preparation of occlusal surface with round bur was very effective in reduction of microleakage incomparison with the traditional pumice slurry and bristle brush.


Article
The effect of extending the head length of carbide fissure bur on it's effectiveness in cutting dentin

Author: Angham G. Al-Hashimi انغام الهاشمي
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2005 Volume: 17 Issue: 3 Pages: 42-44
Publisher: Baghdad University جامعة بغداد

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Background: Extending the head length of carbide fissure bur is one of the major trends in bur design. The Aim of study was to evaluate the effectiveness of one of the major trends in bur design which is the extended head length carbide fissure bur, in cutting dentin.Materials and methods: The cutting of extended head length (EHL) and non extended head length (NEHL) carbide fissure burs were evaluated on dentin specimens mounted in acrylic blocks. The specimens were divided into two groups: Group I Cutting performed with NEHL carbide fissure bur (10 burs), Group II Cutting performed with EHL carbide fissure bur (10 burs). Ten cuts were performed with each bur and a total of 200 cutting rates or CRs (mm/sec) were recorded. The CRs were statistically analyzed using analysis of variance (ANOVA) test, least significant difference (LSD) test, and student t-test.Results: A significant difference (P< 0.5) appeared between CRs of group I after cut 7 and in group II after cut 2.Conclusion: Although, extending the head length of carbide fissure bur enhances it's cutting effectiveness, but such a bur is readily dulled during cutting procedure


Article
11.INTER SPHINCTERIC BOTULINUM TOXIN A INJECTION FOR THE MANAGEMENT OF CHRONIC ANAL FISSURE

Authors: Nashwan Q. Mahgoob نشوان محجوب --- Muhammed M. kamal محمد كامل
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2017 Volume: 15 Issue: 2 Pages: 181-187
Publisher: Al-Nahrain University جامعة النهرين

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Background: Surgical sphincterotomy (SS) has been the most commonly used treatment for chronic anal fissure (CAF). Although effective, it is associated with gas and or fecal incontinence in (0-20%) inter-sphincteric Botulinum Toxin A (BTXA) injection is a non-surgical technique that may be used as an option under certain circumstances for treatment of such condition.Objective: To verify the effectiveness of the BTXA injection in relieving symptoms and healing of chronic anal fissures.Methods: Thirty patients with CAF were treated by BTXA 1 U/kg injected into the inter-sphincteric plane; as an outpatient procedure, patients were re-evaluated after 1 week, and then every 2 weeks until the fissure healed or surgery was required. The patients were followed up for one year by regular attachment through phone call or visit, to evaluate the effects of treatment. Results, complications and follow up were recorded.Results: In 25 patients (83%), the pain was disappeared after the first week; 20 patients (66%) presented with a complete healing of the fissure in a period ranging between 1 to 3 months. Gas incontinence was reported in 2 patients (6%) and solved spontaneously. No major complications were found, in 3 cases (10%) surgery was needed later on.Conclusion: Since it avoids the greater risk of incontinence associated with SS, and it can be done as outpatient procedure without admission or general anesthesia. We recommend the use of BTXA as the first therapeutic approach for patients with chronic anal fissure.Keywords: Botulinum Toxin A, anal fissure.Citation: Nashwan Q. Mahgoob, Muhammed M. kamal. Inter sphincteric botulinum toxin A injection for the management of chronic anal fissure. Iraqi JMS. 2017; Vol. 15(2): 181-187. doi: 10.22578/IJMS.15.2.11


Article
Effect of at Home Dental Bleaching and the Use of Antioxidant on Microleakege of Fissure Sealant : An in Vitro Study

Author: Rayia J Al-Naimi
Journal: Al-Rafidain Dental Journal مجلة الرافدين لطب الأسنان ISSN: 18121217 Year: 2012 Volume: 12 Issue: 19 Pages: 102-108
Publisher: Mosul University جامعة الموصل

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Abstract

Aim of the study: To evaluate in vitro the microleakage of fissure sealant, the effect of using home bleaching agent containing 18% carbamide peroxide and the effect of ethanol as an antioxidant agent on microleakage. Materials and Methods: Twenty four extracted sound human third molars were randomly assigned to 3 groups. After sealant placement, the teeth were thermocycled (125 cycles; 5- 55°C), isolated, immersed in 0.2% methylene blue dye for 24 hours, included in acrylic resin and sec-tioned longitudinally in a buccolingual direction. The sections were analyzed for leakage using an ste-reomicroscope, and a 4-criteria ranked scale was used to score dye penetration. Results: Microleakage scores increased with significant difference between control and bleached group when home bleach was used for fourteen days, also leakage scores decreased with significant difference when ethanol was used after bleaching to reverse the oxidation process, no significant difference was observed between control versus ethanol group. Conclusions: Microleakage scores increased after bleaching because of reduction in enamel bond strength of sealant when the bonding procedure was carried out immediately after bleaching, use of ethanol or other types of antioxidant reduced the amount of microleakage sig-nificantly.


Article
An evaluation of three fissure sealants microleakage with presence or absence of bonding agent through time intervals (In vitro study)

Authors: Ali M. El-mosawi علي الموسوي --- Wesal A. Al-Obaidi وصال العبيدي
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2013 Volume: 25 Issue: 1 Pages: 181-187
Publisher: Baghdad University جامعة بغداد

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Background: Pit and fissure sealant have been considered an outstanding adjunct to oral health care in thedecrease of occlusal caries onset and low progression. The aims of this in vitro study were to evaluate the marginalmicroleakage of three different types of fissure sealants (SDI, Tg and tetric N-flow) by time interval, one day and 45days, in the presence or absence of bonding agent among maxillary and mandibular teeth.Materials and methods: Seventy two sound human maxillary and mandibular first premolar teeth were collectedwhich were free from obvious carious lesions. The teeth were randomly divided into two main equal groups, group (1)and group (2), each group consists of (36) teeth involving equal numbers of maxillary and mandibular teeth. The firstgroup incubated for one day, the second incubated for (45) days. Each group divided into two subgroup; one ofthem treated with bonding agent while the other without. Then each subgroup was treated with three differentmaterials which were; Tg sealant (without fluoride) group (A), SDI sealant (containing fluoride) group (B) and Tetric Nflow(flowable composite) group (C). Each one consist of six teeth involving three maxillary and three mandibular.Then dye penetration tested by using methylene blue dye, then the teeth cleaned and sectioned by sectioningdevice and tested under microscope.Results, the results had shown that, group (C+) in both incubation periods have no microleakage (score 0), but therewas an opposite effect when using bonding agent with sealant materials not containing filler particles that showed asignificant increase in the microleakage rate as shown in groups (A+ and B+). The opposite effect was seen alsowhen used sealant materials containing filler particles but without bonding agent that seen in group (C) during bothincubation periods that showed significant increasing in microleakage rate. While the effect of fluoride was veryclear in decreasing significantly the microleakage rate after (45) days of incubation in both groups that treated withand without bonding agent (groups B and B+). Concerning the anatomical variation, there were no significantchanges in most groups regarding the microleakage rate.Conclusions: Results had shown that the microleakage can be prevented by using of flowable composite containingnanofillers that treated with bonding agent after etching of enamel with 35% phosphoric acid gel


Article
LATERAL INTERNAL SPHINCTEROTOMY FOR TREATMENT OF CHRONIC ANAL FISSURE IN PEDIATRICS
قص العضلة العاصرة الداخلية لعلاج الفطر الشرجي المزمن عند الأطفال

Authors: SAHNED S. JAAFAR سهند جعفر --- QADER M.SALIH قادر محمد صالح --- AZAD A. HALEEM ازاد عبدالجبار حليم
Journal: Duhok Medical Journal مجلة دهوك الطبية ISSN: ISSN: 20717334 (online)/ ISSN: 20717326 (Print) Year: 2018 Volume: 12 Issue: 1 Pages: 24-30
Publisher: University of Dohuk جامعة دهوك

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Abstract

Background: Lateral internal sphincterotomy is a well established surgical technique fortreatment of chronic anal fissure in the adult. The aim of this study was toevaluate theoutcome of lateral internal sphincterotomy in Pediatrics.Subject and Methods: This is a prospective study performed over a period of 4 years fromOctober 2008 to October 2012 on 37 patients with the chronic anal fissure of a durationexceeding three months and history of failure to conservative treatment. All patientsunderwent left lateral internal sphincterotomy through an open technique. The outcome wasevaluated by assessing the effectiveness of this procedure in relieving the symptoms, fissure.Results: There were 26 boys and 11 girls, mean age was 11 months with a range of (6months 12 years), and symptoms were relieved within two weeks in 28 cases and withinone month in 5 cases. 4 patients require postoperative oral laxative for 1-3 months toovercome the withholding behavior. Fissures healed in 34 by eight weeks postoperatively.Parents were satisfied with the outcome in 32 patients. Four patients developed postoperativebleeding, and only one of them was serious and required cauterization, soiling occurred in 3cases. No permanent incontinence was reported.Conclusions: Lateral internal sphincterotomy is an effective and safe surgical technique fortreatment of chronic anal fissure not responding to medical therapy in pediatric.Complications are uncommon, and the risk of incontinence is very minimal if the propersurgical technique is performed

الخلفية والأهداف قص العضلة العاصرة الداخلية الجانبي هي تقنية جراحية راسخة لعلاج الفطر الشرجي المزمن عند البالغين. اجرينا هذه الدراسة لتقيم نتائج هذه التقنية عند الأطفال.طرق البحث: هذه الدراسة الأستطلاعية اجريت على مدى 4 سنوات من أكتوبر 2008 الى أكتوبر 2012 و شملت الدراسة 37 مريضا يعانون من الفطر الشرجي المزمن لمدة تتجاوز الثلاثة اشهر مع عدم الأستجابة للعلاج التحفظي, خضع جميع المرضى لعملية القص الجانبي للعضلة العاصرة الداخلية بالتقنية المفتوحة ثم تم تقيم النتيجة من خلال تقييم فعالية هذه التقنية في تخفيف الأعراض, شفاء الفطر, رضا الوالدين و نسبة حدوث المضاعفات.النتائج: شملت الدراسة 26 صبيا و 11 فتاة مع متوسط عمر 11 شهر( 6 شهر-12 سنة), تم ملاجظة تخفيف الأعراض في غضون اسبوعين في 28 حالة وخلال شهر واحد في 5 حالات, في 4 حالات تم اعطاء الأدوية الملينة لمدة 1-3 شهر للتغلب على الأمساك. شفي الفطر في 34 حالة خلال 8 اسابيع من تاريخ العملية. كانت النتيجة مرضية جدا للوالدين في 32 حالة, في 4 حالات حدث نزف دموي ولكن في حالة واحدة تطلب الوضع اجراء كوي للنزف, حدث التهاب في 3حالات استجابت للمضادات الحيوية, لم تحدث اية حالة سلس غوطي.الاستنتاجات : القص الجانبي للعضلة الداخلية العاصرة هي تقنية جراحية فعالة و أمنة لعلاج الفطر الشرجي المزمن الذي لايستجيب للعلاج التحفظي عند الأطفال. المضاعفات هي غير شائعة و خطر سلس الغوط هي في الحد الأدنى اذا تم تنفيذ هذه التقنية بصورة صحيحة.


Article
THE EFFECT OF FISSURE MORPHOLOGY ON CARIES SEVERITY OF ADULTS IN NORTH IRAQ
تاثير شكل الشقوق الطاحنه على شدة النخر عند البالغين في شمال العراق

Author: Faraed D. Salman
Journal: AL-TAQANI مجلة التقني ISSN: 1818653X Year: 2011 Volume: 24 Issue: 4 Pages: 29-37
Publisher: Foundation of technical education هيئة التعليم التقني

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Abstract

Background: The presence of pits and fissures are normal occurrence found in molars, premolars. They can be considered as areas with high susceptibility to caries lesion.Materials and Methods: The extracted premolars were 655 for orthodontic purposes. Ekstrand clinical severity index (1995) was used to assess the severity of primary fissure occlusal caries. They were divided into 5 subgroups on the basis of fissure morphology (I, V, U, IK and Y types)(Nagano,1961). Thereafter, the teeth were sectioned into buccolingual direction in central fossa and microscopically analyzed by stereomicroscope (150× magnification).Aim of study: The study was designed to examine the effect of fissure morphology on primary caries of occlusal fissures in premolars in North of Iraq. Results : V– and IK– shaped fissures were found to have the maximum percentage (48% and 22.44%, respectively). Percentage was very poor for I (18.77%), Y (18.01%) and U (17.09%) types of fissureConclusions: V– and U– shapes have less severity of dental caries in comparison with I–, Y– and IK– types with increasing severity index scores.

ان وجود الوهاد والشقوق هو تكوين طبيعي في الطواحن والضواحك ،فهي تعتبر مناطق عالية لحدوث النخر.صممت هذه الدراسة لفحص تاثير شكل الشقوق الطاحنة على النخر الابتدائي في هذه الشقوق للضواحك في شمال العراق .تم استخدام مؤشرEkstrand(1995) لقياس شدة النخرعلى السطوح الطاحنة. تم قلع (655) ضاحك مستخدمة لغرض التقويم ،قسمت الاسنان الى خمس مجاميع حسب شكل الشقوق لمؤشر )Nagano (1961. قطعت الاسنان في مركز الوحدة الدهليزية اللسانية ثم فحصت بالستيروميكروسكوب قوة تكبيره 150 مرة .اظهرت النتائج ان نوع الشقوق ((V&IK كان اعلى نسبة(22.44%&48 %) على التوالي متبوعا ب (I) (18.77%)،) (Y) 18.01) ثم (U) (17.09%). ظهران الاشكال ( (U&Vتمتلك اقل شدة للنخر مقارنة ب ( IK,I,Y) مع زيادة درجات شدة النخر مع عدم وجود فروقات معنوية لكلا الجنسين حسب توزيع اشكال الاخاديد المختلفة.


Article
Effect of air abrasion treatment on microleakage of a pit and fissure sealant (in vitro study)

Author: Dr. Baydaa Hussein ,B.D.S, MSc. * د.بيداء حسين
Journal: MUSTANSIRIA DENTAL JOURNAL مجلة المستنصرية لطب الاسنان ISSN: 18138500 Year: 2007 Volume: 4 Issue: 2 Pages: 162-168
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

The aim of this study was to compare in vitro the microleakage of a pit and fissure sealant after different enamel surface treatments: (1) acid etching only, (2) air abrasion only, and (3) air abrasion followed by acid etching.Thirty sound human upper premolars were used in this study. The teeth were divided into three groups according to the type of treatment prior to sealant application: Group 1 (in which the occlusal surface was etched with 37% phosphoric acid gel for 30 seconds), Group 2 (in which the occlusal surface was air-abraded for 10 seconds with sodium hydrogen carbonate powder), and Group 3 (in which the occlusal surface was air-abraded as in group 2 and then acid etched as in group 1). Then a light-cured pit and fissure sealant (Fisseal, Promedica, Germany) was applied to the central fissure in the occlusal surface of each tooth and light cured for 20 seconds. Then the teeth were thermocycled between 5ºC and 55ºC for 10 cycles, immersed in 0.5% basic fuchsine dye for 24 hours at room temperature, embedded in auto-polymerizing acrylic resin, sectioned longitudinally bucco-lingually, and examined under a stereomicroscope for dye penetration.The results of this study showed that the highest mean of microleakage scores was in group 2 (air abrasion group), while the lowest mean of microleakage scores was in group 3 (air abrasion + acid etching), with statistically highly significant difference (p<0.01) between group 1 and group 2, and between group 2 and group 3, with statistically non-significant difference between group 1 and group 3 (p>0.05).Air abrasion treatment prior to sealant application was not effective in reducing microleakage and should be followed by acid etching.

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