[Effect of early perceptual-motor enrichment on later fine motor development process of infants]

There is an agreement on impression of environment on the development in different ways. The environment effect could be passive or active. The environment enrichment is a passive method which is used to show the effect of environment on the development during infancy. The purpose of this study was to investigate the effect of early perceptual-motor enrichment on later fine motor development process of infants. Fifteen 5 to 8-months-old healthy infants participated randomly in this study. According to their age, participants were divided homogenously in two groups: training [n=8, ages=6.5 +/- 2] and non-training [n=8, ages=6.5 +/- 2]. Training group had 36 training sessions [3 times in a week] for an hour at a perceptual-motor enrichment environment [involve vary manipulation and locomotion tools]. After 36 training sessions, at the first assessment stage, infant fine motor skills were evaluated by Peabody motor development scale. Three months later, all infants were kept in similar and normal condition. At the later assessment stage, after this three months, infant fine motor skills were evaluated by same scale. Data were analyzed by mixed ANOVA2 [group] x [stage]. Results indicated that in fine motor age equivalent, main effect of group [F[1,10]= 10.53, P=.009] and main effect of assessment stages [F[1,10] =96.33, P=.001] was significant. Interaction between groups and assessment stages [F[1,10]=2.58, P=.13] was not significant. Also, in fine motor scaled score, main effect of group [F[1,10]=6.65, P=.02] and main effect of assessment stages [F[1,10]=32.93, P=.001] was significant. Interaction between groups and assessment stages [F[1,10]=24, P=.63] was not significant. Generally, results show that training and experience have positive effect on later fine motor skills development of infant

[ comparison between the results of fissurectomy and lateral internal sphincterotomy in the management of chronic anal fissure]

Although lateral internal sphincterotomy is an effective treatment of chronic fissure in ano, it may lead to serious complications, of these, incontinence to flatus and fecal soiling are the most distressing. To avoid such complications, we proposed fissurectomy as an alternative surgical treatment. Totally, 62 consecutive patients through the sequential sampling were divided into two groups. 30 patients underwent fissurectomy [F] and 32 underwent lateral internal sphincterotomy [LIS]. After a median follow-up of 22 months, we compared the results of the two procedures. In addition to frequent visits on a predetermined basis, a telephone inquiry into fissure recurrence and continence status was made. All patients in either group were pain free and without bleeding within one week. In both groups urinary retention was noted in one patient. Incontinence to flatus was in the LIS group in two [6.2%] patients but no incontinence was noted in the F group. There was one patient [3.1%] with fissure recurrence in the LIS group but no one in the F group. No patient in either group afflicted with anal stenosis or perianal infections. All wounds healed within 8 weeks. 29 patients [96.6%] in the F group and 28[87.5%] in the LIS group reported satisfactory results with their procedure. In the surgical treatment of chronic anal fissure not responding to conservative management, fissurectomy may be a sphincter-sparing alternative and perhaps preferable surgical technique with less total complications