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 study tests the effect of a large number of independent variables that control the growth of the total productivity, which amounted to 112 variables, gathered from what is mentioned in the specialized theoretical and applied literature. The data for these variables were taken from global reports of sound international organizations and reliable databases covering the period 1991-2016. The data of the dependent variable, the growth of the total factor productivity, were taken from the database of the world development indicators. The study covered 61 countries for which data were available. The study included three regression models to explain
... Show MoreBackground: Breast cancer is the commonest type of malignancy worldwide and in Iraq. It is a serious disease that affects the general health and cause systemic changes that affect the physical and chemical properties of saliva leading to adverse effects on oral health. This study was conducted toassess the tumor marker CA15-3 and selected elements in saliva and their relation to oral health status among breast cancer patients compared to control group. Materials and Methods: The total sample consisted of 60 women aged 35-45 years. 30 women were newly diagnosed with breast cancer before taking any treatment and surgery (study group) and 30 women without clinical signs and symptoms of breast cancer as a control group. Dental caries was record
... Show MoreThis research aims to know the effectiveness of teaching with a proposed strategy according to the common Knowledge construction modelin mathematical proficiency among students of the second middle class. The researchers adopted the method of the experimental approach, as the experimental design was used for two independent and equal groups with a post-test. The experiment was applied to a sample consisting of (83) students divided into two groups: an experimental comprising (42) students and a control group, the second comprising (41) students., from Badr Shaker Al-Sayyab Intermediate School for Boys, for the first semester of the academic year (2021-2022), the two groups were rewarded in four variables: (chronological age calculated in mo
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This research aims to analyze the reality of the production process in an assembly line Cars (RUNNA) in the public company for the automotive industry / Alexandria through the use of some Lean production tools, and data were collected through permanence in the company to identify the problems of the line in order to find appropriate to adopt some Lean production tools solutions, and results showed the presence of Lead time in some stations, which is reflected on the customer's waiting time to get the car, as well as some of the problems existing in the car produced such as high temperature of the car, as the company does not take into account customer preferences,
... Show MoreRice is a major staple food for more than two thirds of the world population. Pathogenesis-related proteins-10 (PR10) have a range of 154 to 163 amino acid with molecular weight ~ 17 kDa. They are acidic and generally intracellular and cytosolic proteins accumulate in plants in response to biotic and abiotic stresses. In the present study, a PR10 gene and its corresponding protein were characterized in O. sativa, O. barthii, O. glaberrima, O. glumipatula, O. meridionalis, O. nivara, O. rufipogon and O. punctata. The results revealed a narrow range of variation at both DNA and protein levels in all examined species except O. glumipatula. The latter showed a relatively
... Show MoreThe increasing use of antiseptic compounds creates selective pressure cause emergence of antiseptic resistance among Staphylococcus aureus .Resistance mechanism of antiseptic is driven mainly by multi drug resistant (MDR) efflux protein.Sixty five isolates of S.aureuswere collected from different clinical sources and subjected to 11 antibiotics most of them are recognized by efflux systems as extruded substrates. Range of efflux activity was estimated using cartwheel method. Simultaneous discrimination of antiseptic coding genes (qacA/B, smr and norA)as well as nuc and mecA genes among multidrug resistantS.aureus(MRSA) isolates was preformed using multiplex PCR assay
... Show MoreOrganic soil is problematic soils in geotechnical engineering due to its properties, as it is characterized by high compressibility and low bearing capacity. Therefore, several geotechnical techniques tried to stabilize and improve this soil type. In this study, sodium silicate was used to stabilize sand dune columns. The best sodium silicate concentration (9%) was used, and the stabilized sand dune columns were cured for seven days. The results for this soil were extracted using a numerical analysis program (Plaxis 3D, 2020).In the case of studying the effect of (L/D) (where ‘’L” and ‘’D’’ length and diameter of sand dune columns) of a single column of sand dunes stabilized with sodium silicate with a diff
... Show MoreThis study examines the relationship between the increase in the number of tourists coming to Tunisia and GDP during the period 1995-2017, using the methodology of joint integration, causal testing and error correction model. The research found the time series instability of the logarithm of the number of tourists coming to Tunisia and the output logarithm but after applying the first differences, these chains become stable, THUS these time series are integrated in the first differences. Using the Johansson method, we found the possibility of a simultaneous integration relationship between the logarithm of the number of tourists coming to Tunisia and the logarithm of GDP in Tunisia, and there is a causal relationship in one direc
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