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 aim of this study was to critically appraise and synthesize the best available evidence on the effectiveness of interventions suitable for delivery by nurses, designed to enhance cardiac patients' adherence to their prescribed medications.
Cardiac medications have statistically significant health benefits for patients with heart disease, but patients' adherence to prescribed medications remains suboptimal.
A systematic quantitative review of intervention effects.
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The deficiency of potable water resources and energy supply is emerging as a significant and concerning obstacle to sustainable development. Solar and waste heat-powered humidification dehumidification (HDH) desalination systems become essential due to the severe impacts of global warming and water shortages. This problem highlights the need to apply boosted water desalination solutions. Desalination is a capital-intensive process that demands considerable energy, predominantly sourced from fossil fuels worldwide, posing a significant carbon footprint risk. HDH is a very efficient desalination method suitable for remote areas with moderate freshwater requirements for domestic and agricultural usage. Several operational and maintenance conce
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The power generation of solar photovoltaic (PV) technology is being implemented in every nation worldwide due to its environmentally clean characteristics. Therefore, PV technology is significantly growing in the present applications and usage of PV power systems. Despite the strength of the PV arrays in power systems, the arrays remain susceptible to certain faults. An effective supply requires economic returns, the security of the equipment and humans, precise fault identification, diagnosis, and interruption tools. Meanwhile, the faults in unidentified arc lead to serious fire hazards to commercial, residential, and utility-scale PV systems. To ensure secure and dependable distribution of electricity, the detection of such ha
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The objective review is to inspect the involvement of Interleukin-6 (IL-6) in rheumatoid arthritis (RA) and to highlight the role of IL-6 and its variants in the pathogenesis of RA and response to anti-IL-6 agents. Several genetic and environmental risk factors and infectious agents contributed to the development of RA. Interleukin-6 is engaged in self-targeted immunity by modifying the equilibrium between T regulatory (T-reg) and T helper-17 (Th-17) cells. The evidences reported that IL-6 parti
Enamel White Spot Lesions (EWSLs) are a common dental condition characterized by being opaque or chalky white in appearance. In this review, an overview of the etiology, prevention, and treatment techniques for EWSLs is presented. Enamel demineralization caused by bacteria in dental plaque which releases acids upon the consumption of fermentable carbohydrates causing mineral loss is thought to be the main cause of those lesions, which could be predisposed through orthodontic treatment, poor diet, inadequate oral hygiene and certain medical conditions. So, sustaining an adequate carbohydrate consumption, proper fluoride exposure and good oral hygiene are some of the practices which aid in these lesions’ prevention. Although the suc
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AASAH Enass J Waheed, Shatha MH Obaid, Research Journal of Pharmaceutical, Biological and Chemical Sciences, 2019 - Cited by 5
This review covers recent progress in the synthesis of curcumin and the bioactivity of semisynthetic and synthetic analogs of curcumin. The review also shows how curcumin is a useful intermediate for the synthesis of more complex organic molecules; historical perspective; the process of preparing the metal complexes and characterization the produced complexes using various spectral and other techniques; shows the importance of curcumin and its derivatives for their potential applications in medical devices and broad-spectrum of medical application such as antibiotic ointment, alternative therapeutics, antifungal, and antibacterial activities
Fibromuscular dysplasia (FMD) is a noninflammatory and nonatherosclerotic arteriopathy that is characterized by irregular cellular proliferation and deformed construction of the arterial wall that causes segmentation, constriction, or aneurysm in the intermediate-sized arteries. The incidence of FMD is 0.42–3.4%, and the unilateral occurrence is even rarer. Herein, we report a rare case of a localized extracranial carotid unilateral FMD associated with recurrent transient ischemic attacks (TIAs) treated by extracranial-intracranial bypass for indirect revascularization. The specific localization of the disease rendered our case unique.
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