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.
This narrative review focused on research investigating the impact of loneliness on the prevalence of dementia and its relationship with other risk factors. A comprehensive and rigorous search was conducted using a variety of scientific databases with specific keywords to identify all prior studies that examined the correlation between dementia and loneliness. The inquiry was confined to articles published in English from January 2017 to March 2024. The narrative review identified a consensus regarding the role of loneliness in enhancing the risk of all‐cause dementia, with a particular emphasis on the subjective perception of loneliness. This phenomenon may be caused by the sensations of exclusion, discrimination, and alienation that are
... Show MoreThe paper is highlighting the athletics and heroic sports which encouraged and played at Greek and Islamic period. The paper is identifying the Islamic athletics and heroic sport and compare them with Greek sports, as it is the model of sports while the sport during the Islamic period was not undertaken by scientific researches or articles even in Wikipedia. Although, this period was encouraged and practice many sports such as archery, sword grappling and wrestling, equestrianism, jogging and running whereas there are many Arabic references revealed during the Islamic 610 A.D. while the Greek and Olympic was known at 732 A.D. The paper is followed the literature review and historical to shied a light scientifically about tradition
... Show MoreSecondary trigeminal neuralgia (STN) results from an identifiable underlying pathology, including tumor compression, multiple sclerosis, arteriovenous malformations, hypertension, structural lesions, inflammation, trauma, or familial genetic conditions. This study, through a comprehensive review of the literature in PubMed, Google Scholar, Web of Science, and the Cochrane Library, explores the multifaceted aspects of STN. This study delves into the diverse etiological factors, focusing on the pathophysiological mechanisms that lead to trigeminal nerve dysfunction. The clinical manifestations of STN often overlap with those of primary trigeminal neuralgia, creating diagnostic challenges and necessitating a thorough evaluation that in
... Show MoreBackground: Thyroid surgery is most common endocrine surgery in general surgical practice. Objectives: the aim of this work is to evaluate the feasibility, benefits and outcomes of open mini-incision thyroidectomy and compared the results with that of conventional thyroidectomy. The comparison between the two groups was in term of incision length, amount of blood loss, time of operation, postoperative pain, hospital stay and the cosmetic outcomes.Type of the study: this is a single-blinded randomized controlled studyMethods: This study compared the advantages and outcomes of 22 patients subjected to mini-incision thyroidectomy (Group A) with the equal numbers of patients subjected to conventional thyroidectomy (Group B).Results: the oper
... Show MoreThis study looks into the many methods that are used in the risk assessment procedure that is used in the construction industry nowadays. As a result of the slow adoption of novel assessment methods, professionals frequently resort to strategies that have previously been validated as being successful. When it comes to risk assessment, having a precise analytical tool that uses the cost of risk as a measurement and draws on the knowledge of professionals could potentially assist bridge the gap between theory and practice. This step will examine relevant literature, sort articles according to their published year, and identify domains and qualities. Consequently, the most significant findings have been presented in a manne
... Show MoreCurrently, there is an intensive development of bipedal walking robots. The most known solutions are based on the use of the principles of human gait created in nature during evolution. Modernbipedal robots are also based on the locomotion manners of birds. This review presents the current state of the art of bipedal walking robots based on natural bipedal movements (human and bird) as well as on innovative synthetic solutions. Firstly, an overview of the scientific analysis of human gait is provided as a basis for the design of bipedal robots. The full human gait cycle that consists of two main phases is analysed and the attention is paid to the problem of balance and stability, especially in the single support phase when the biped
... Show MoreCitric acid is an essential ingredient for the manufacture of (12) key industrial chemicals. Citric acid use is increasing steadily with a high annual growth rate as a result of the development of ever more sophisticated applications. Citric acid is widely utilized in the food and pharmaceutical industries due to its low toxicity when compared to other acidulous. Other uses for citric acid can be found in cleaning supplies and detergents. Based on information from a review of the literature, Citric acid production substrates and methods for surface fermentation, submerged fermentation, solid-state fermentation, and international market expansion are all covered in the current review study. Finally, there is still much to learn about the
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This study turns about The Military Thinking and His Islamic balance in
The Caliph Ali Bin Abi Talib ( peace is on him ) Compact to Malek Al Ashtar
(God be pleased on him )The military field is very wide in all intellectual and
practically effects at The Caliph Ali Bin Abi Taleb(peace is on him ). Its
considered the first seed for islam ,therefore,there are a lot from military
situtions which proved his practical experience in these affairs , and away
from the details of war and practical battles lets search the sample and the
academic study for fair military thinking (justice) in The Compact of Caliph Ali
to Malek Al Ashtar when he became the ruler of egypt.
The military fair thinking determines fr
The phenomenon of negative behavior has studied as a social and psychological phenomenon that effect on the performance and life of workers inside and outside the organization. The adoption of this phenomenon is studied in terms of the role of the internal environment of the organization in addressing this behavior, being the variables belong to the field of organizational behavior to see the results of those variables on the Iraqi organizations, since the specificities of it differ from the rest of the Arab and foreign environments. Therefore, this study focused on testing the relationship of the internal environment of the organization and its role in addressing the negative behavior of the workers.
thi
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