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.
The problem of research is that there are ways to protect and sustain environmentally important sites in Iraq. There are no documentary sources for these sites, such as the natural landscape of natural and important natural resources, which suffer from severe environmental neglect
Despite the principle of separation of powers brought by the French Revolution, which entrusted the task of drafting legislation and its amendment to the legislative authority and the task of settling disputes and settling them in the judiciary. However, since that date, the French judiciary has played a major role in the development of French civil law (In spite of all the economic and social developments that have taken place in French society throughout these years) since its promulgation until February of 2016, the date of the Legislative Decree No. 131 of the year 2016 A modification is the largest in the history of the French Civil Code (which was the judicial precedents in which a significant impact), was assisted by the French judic
... Show MoreFind cares studying ways in the development of industrial products and designs: the way the progressive development (how typical) and root development (jump design), was the aim of the research: to determine the effectiveness of the pattern and the jump in the development of designs and industrial products. After a process of analysis of a sample of research and two models of contemporary household electrical appliances, it was reached a set of findings and conclusions including:1-leaping designs changed a lot of entrenched perceptions of the user on how the product works and its use and the size and shape of the product, revealing him about the possibilities of sophisticated relationships with the product, while keeping the typical desi
... Show MoreThe cyanobacterial neurotoxin
This study aims to formulate azithromycin oleogel to locally treat skin infections such as acne vulgaris and skin wound infection. Providing a form of azithromycin that can be administered topically is highly desired to prevent unwanted systemic complications including diarrhea, nausea, and abdominal pain. Additionally, it will avoid first pass metabolism, improves patient acceptance, provides an alternative in nauseated patients, decreases the dose by direct contact with the pathological site, and provides a noninvasive and convenient mode of administration. Furthermore, for treating wound infections, the gel will act as a scaffold biomaterial for wound closure besides its antibacterial effect. Herein, we propose the use of grapeseed oil-b
... Show MoreVanadium dioxide nanofilms are one of the most essential materials in electronic applications like smart windows. Therefore, studying and understanding the optical properties of such films is crucial to modify the parameters that control these properties. To this end, this work focuses on investigating the opacity as a function of the energy directed at the nanofilms with different thicknesses (1–100) nm. Effective mediator theories (EMTs), which are considered as the application of Bruggeman’s formalism and the Looyenga mixing rule, have been used to estimate the dielectric constant of VO2 nanofilms. The results show different opacity behaviors at different w
Psychosocial Alienation is a modern concept that arises from the capitalist and materialistic conceptions of individuals. The evergrowing competitive nature of domestic societies crystallised the concept in its modern form. The intensity of the rapid changes in the urbanised societies prevents the individuals from exploring their inner selves. Thus, a new generation is created with an alienation crisis which is reflected inward towards the self and outwards toward society. Alan Ayckbourn (1939), A British playwright, presents Alienated characters inspired by his life on and off stage. He explores their Alienation and their path toward recovery and self-realization. A Brief History of Women (2017) Ayckbourn explores the depth of the individu
... Show MoreThe application of the test case prioritization method is a key part of system testing intended to think it through and sort out the issues early in the development stage. Traditional prioritization techniques frequently fail to take into account the complexities of big-scale test suites, growing systems and time constraints, therefore cannot fully fix this problem. The proposed study here will deal with a meta-heuristic hybrid method that focuses on addressing the challenges of the modern time. The strategy utilizes genetic algorithms alongside a black hole as a means to create a smooth tradeoff between exploring numerous possibilities and exploiting the best one. The proposed hybrid algorithm of genetic black hole (HGBH) uses the
... Show MoreTheoretical trends have appeared Which posed the concept of biological structures in contemporary architecture concept, Spread through the emergence of architectural production that reflect and indicate the nature of the construction structures based on the ideas and principles of biological structures in biological science: Despite the emergence of many architectural proposals that tried to explain the concept in the field of architecture, but it is not dealt with in depth and not given a comprehensive definition: So there was need to search for the concept and its beginning in the biological field as a general framework down to the field of architecture for the purpose of reducing the limits of their search framework T
... Show MoreThe work in this paper focuses on the experimental confirming of the losses in photonic crystal fibers (PCF) on the transmission of Q-switched Nd:YAG laser. First HC-PCF was evacuated to 0.1 mbar then the microstructure fiber (PCF) was filled with He gas & gas. Second the input power and output power of Q-switched Nd:YAG laser was measured in hollow core photonic bandgap fiber (HCPCF). In this work loss was calculated in the hollow core photonic crystal fiber (HCPCF) filled with air then N2, and He gases respectively. It has bean observed that the minimum loss obtained in case of filling (HC-PCF) with He gas and its equal to 15.070 dB/km at operating wavelength (1040-1090) nm.