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.
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Research Summary :
Praise be to God, Lord of the Worlds, and prayers and peace be upon the Master of the Messengers, his family and all his companions, then after:
This is brief research that contained between its two covers one of the jurisprudence rules derived from Islamic Sharia that guarantees the right of others, in case of forcing to do the prohibited act, and it is a restriction of the rule: “Necessities allow prohibitions” and “Hardship brings facilitation” and support for the rule: “Necessities are valued.” It is an origin in alleviating the taxpayer definitely , and the study has briefly shown some of the jurisprudential appli
... Show MoreAll major organs may be impacted by the connective disease systemic lupus erythematosus, a separate risk factor for coronary artery disease (CAD). Adhesion molecules like intercellular adhesion molecules (ICAM) and vascular cell adhesion molecules (VCAM) can detect endothelial damage and dysfunction, which appear to play a crucial role. This study investigated whether people with SLE had elevated subclinical and clinical atherosclerosis risk factors. Traditional CAD risk factors such as smoking, hypertension, and hyperlipidemia cannot entirely explain this elevation. It is thought that immunological dysfunction also increases CAD risk in SLE patients. The study aimed to assess early endothelial changes in SLE Iraqi female patients w
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Abstract
Background: The novel coronavirus 2 (SARS?CoV?2) pandemic is a pulmonary disease, which leads to cardiac, hematologic, and renal complications. Anticoagulants are used for COVID-19 infected patients because the infection increases the risk of thrombosis. The world health organization (WHO), recommend prophylaxis dose of anticoagulants: (Enoxaparin or unfractionated Heparin for hospitalized patients with COVID-19 disease. This has created an urgent need to identify effective medications for COVID-19 prevention and treatment. The value of COVID-19 treatments is affected by cost-effectiveness analysis (CEA) to inform relative value and how to best maximize social welfare through eviden
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The language that consists of only twenty-eight letters, but it is so broad that we are unable to understand it from all sides and this expansion is mainly caused by imagination, so Arab imagination, whose language goes in all directions And as it always responds to our ears, ancient critics divide imagination into holistic and partial But the language is not limited to these parts only. Do we wonder, where is the structural method of wishing, hope, questions and other methods of all this? In this paper, we try to show the importance of the method of writing in moving imagination in an interactive way, and what is related to human feelings in most, if not all, of its methods By studying the poetry of the believers in the Ahl al-Bayt, pea
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Husbands’ violence towards their wives is one of the greatly important issues in social sciences. Accordingly, the current study aims at determining the levels of violence practiced by husbands towards their wives to propose a professional program from the perspective of the general practice of social work to overcome such a phenomenon. The study is descriptive in nature, where the researcher has used a comprehensive social survey method. To achieve the goal of the study, the researcher has prepared a questionnaire that consisted of two parts. The first part contains the primary data of the two sections, and the second contains (38) phrases distributed over four axes to measure the levels and types of violence among the sample’s memb
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The importance of the research from a practical point of view lies in the fact that it presents a set of statistics and data that give a clear picture of how the Iraqi newspapers (the subject of the study) deal with the visit of "Pope Francis" to Iraq ، and what are the most prominent indicators and manifestations of that visit in promoting societal peace among the Iraqi public. From a scientific point of view، the research provides another scientific addition to the media library، especially with regard to journalistic treatments and methods of framing the Arab international press for the subject of the visit، which could be a starting point for other researchers to complete qualitative research in this field. The research prob
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