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 current research deals with the "The role of organizational change in the achievement of strategic success" Who are getting increased attention to being one of the important topics and relatively new, And which have a significant impact on the future of the organization So there is a need for this research, which aims to identify the role of organizational change across dimensions (technology, organizational structure, human resources, organizational culture) in the strategic success through its components (a specific strategy, effective implementation, innovation, customer satisfaction)، And that by two main hypotheses, branched about eight hypothes
... Show MoreBackground: Optimal root canal retreatment was required safe and efficient removal of filling material from root canal. The aim of this in vitro study was to compare the efficacy of reciprocating and continuous motion of four retreatment systems in removal of root canal filling material. Materials and Methods: Forty distal roots of the mandibular first molars teeth were used in this study, these roots were embedded in cold clear acrylic,roots were instrumented using crown down technique and rotary ProTaper systemize Sx to size F2 ,instrumentation were done with copiousirrigation of 2.5% sodium hypochlorite and 17% buffered solution of EDTA was used as final irrigant followed by distilledwater, roots were obturated with AH26 sealer and Prota
... Show MoreBackground: A successful endodontic treatment is aimed at the sterilization of the entire pulp space. The use of extracts from Rhamnus prinoides as a novel irrigating material for root canal has not been studied . Hence, the antimicrobial efficacy of the alcoholic extract of Rhamnus prinoides as an irrigation material against E. faecalis was evaluated in comparison with the 2.5% sodium hypochlorite (NaOCL) solution used for root canals of permanent teeth. Methods: A total of 30 single-rooted human permanent teeth were thoroughly cleaned, shaped, and disinfected. Then, each tooth was subjected to a two-week infection with Enterococcus faecalis at 37 °C . Afterward, the samples were divided into three groups (10 teeth per group): 0.9
... Show MoreAvascular necrosis have always presented great challenges to orthopedic surgeons and patients, remain in many ways today the unsolved dilemma. Varieties of non-vascularized bone grafting techniques preceded by core decompression have been proposed with varying degrees of success. O bb j ee cc t i vv ee ss : The aim of this study is to review the the value of core decompression and non-vascularized tibial bone strip graft treatment for early stages of non-traumatic osteonecrosis stage II & III according to stein burg staging . M ee t hh oo dd ss : prospectively reviewed 26 patients (32 hips) with osteonecrosis of the femoral head between June 2006 and December 2013 at Imam Ali hospital in Sader city & Al-Wasity teaching hosp
... Show MoreBackground: The incorporation of rubber has not been entirely successful because it can have detrimental effects on the transverse Strength and hence the rigidity of the denture base. Materials and methods: Zirconium oxide nanoparticales were coated with a layer of trimethoxysilylpropylmethacrylate (TMSPM) before sonication in monomer (MMA) with the percentages 3% by weight then mixed with powder using conventional procedure.(100) samples were prepared and divided into five groups according to the test performed ,Each group consisted of 20 specimens and these were subdivided into 2 groupsGroup (A): control group (10 specimens of high impact acrylic resin without zirconium oxide) and Group (B):zirconium oxide group(10 specimens of high impac
... Show MoreStriae distensae SD or stretch mark are frequent skin lesion that cause considerable aesthetic concern. The 1064nm long pulsed Nd:YAG Laser has been used to promote an increase in dermal collagen and is known to be a Laser that has a high affinity to vascular chromphores. Also by using fractional CO2 Laser 10600nm as an effective modality in treatment of striae distensae SD. It works to stimulate fibroblast and enhance Collagen formation, which is important for newly generated skin tissue.
Objectives: This study aims to verify the efficacy of long pulsed Nd: YAG Laser (1064nm) in the treatment of immature striae distensae (SD) and the efficacy of C02 fractional Laser (10600nm) in treatment o
... Show MoreSome new norms need to be adapted due to COVID-19 pandemic period where people need to wear masks, wash their hands frequently, maintain social distancing, and avoid going out unless necessary. Therefore, educational institutions were closed to minimize the spread of COVID-19. As a result of this, online education was adapted to substitute face-to-face learning. Therefore, this study aimed to assess the Malaysian university students’ adaptation to the new norms, knowledge and practices toward COVID-19, besides, their attitudes toward online learning. A convenient sampling technique was used to recruit 500 Malaysian university students from January to February 2021 through social media. For data collection, all students
... Show MoreBackground Many countries recommend the use of long-acting reversible contraceptive intrauterine device immediately after cesarean delivery. The cesarean delivery rate in Iraqi public hospitals is 32.2% and may reach 85.8% in private hospitals. Immediate post-partum intrauterine device insertion at cesarean is rarely done in Iraq. Objectives To assess the safety and practicality of immediate post-partum intrauterine device insertion during cesarean delivery for family planning and pregnancy spacing in Iraqi women. Subjects and Methods A single arm clinical trial included 150 eligible women who attended Al-Elwiyah Maternity Teaching Hospital or Al Hayat Rahibat Hospital for term delivery. A copper intrauterine device was placed in the ute
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