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 research is to use robust technique by trimming, as the analysis of maximum likelihood (ML) often fails in the case of outliers in the studied phenomenon. Where the (MLE) will lose its advantages because of the bad influence caused by the Outliers. In order to address this problem, new statistical methods have been developed so as not to be affected by the outliers. These methods have robustness or resistance. Therefore, maximum trimmed likelihood: (MTL) is a good alternative to achieve more results. Acceptability and analogies, but weights can be used to increase the efficiency of the resulting capacities and to increase the strength of the estimate using the maximum weighted trimmed likelihood (MWTL). In order to perform t
... Show MoreBackground: Lack of durability of the bond of the dental adhesive systems to tooth structure is one of the most important problems in tooth colored restorative work. This in vitro study was performed to evaluate the effect of 2% chlorhexidine gluconate(CHX) on dentin bond strength by using total etch adhesive system at twenty-four hours and three months of water storage. Material and methods:A flat dentin surface was prepared for forty sound human maxillary premolar teeth which were acid etched with 36% phosphoric acid gel after being divided randomly into four groups of ten teeth each according to storage time and CHX application, theCHX was applied for 60 seconds before adhesive application for groups I and III which were tested after twe
... Show MoreFour electrodes were synthesized based on molecularly imprinted polymers (MIPs). Two MIPs were prepared by using the diclofenac sodium (DFS) as the template, 2-hydroxy ethyl metha acrylate(2-HEMA) and 2-vinyl pyridine(2-VP) as monomers as well as divinyl benzene and benzoyl peroxide as cross linker and initiator respectively. The same composition used for prepared non-imprinted polymers (NIPs) but without the template (diclofenac sodium). To prepared the membranes electrodes used different plasticizers in PVC matrix such as: tris(2-ethyl hexyl) phosphate (TEHP), tri butyl phosphate (TBP), bis(2-ethyl hexyl) adipate (BEHA) and tritolyl phosphate (TTP). The characteristics studied the slop, detection limit, life time and linearity range of DF
... Show MoreWith the increasing demands to use remote sensing approaches, such as aerial photography, satellite imagery, and LiDAR in archaeological applications, there is still a limited number of studies assessing the differences between remote sensing methods in extracting new archaeological finds. Therefore, this work aims to critically compare two types of fine-scale remotely sensed data: LiDAR and an Unmanned Aerial Vehicle (UAV) derived Structure from Motion (SfM) photogrammetry. To achieve this, aerial imagery and airborne LiDAR datasets of Chun Castle were acquired, processed, analyzed, and interpreted. Chun Castle is one of the most remarkable ancient sites in Cornwall County (Southwest England) that had not been surveyed and explored
... Show MoreThe research aims to develop a proposed mechanism for financial reporting on sustainable investment that takes the specificity of these investments.
To achieve this goal, the researcher used (what if scenario) where the future financial statements were prepared for the year 2026, after completion of the sustainable project and operation, as the project requires four years to be completed.
The researcher relied on the results of the researchers collected from various modern sources relevant to the research topic and published on the internet, and the financial data and information obtained to assess the reality of the company's activity and its environmental, social, and economic i
... Show MoreThe scope of the world of translation is an area filled with different types of translations, whether translations of scientific, social, political or economic in addition to the other types are endless, but the translation problematic grammatical that may confront us if we proceed to translate any subject are important issues that must Translator whether translators or interpreters that puts it into consideration and attaches great importance to the translation is very clear and without any ambiguity. One of these forms of grammatical task is to translate the relative pronoun (que) from Spanish into Arabic language, which revolves around the subject of this research.
The relative pron
... Show MoreBackground: Enterococcus faecalis (E. faecalis) is a prototypical resistant bacterium in root canal infections and a leading cause of endodontic treatment failure. German chamomile (Matricaria chamomilla) flower extract has been used as a traditional medicine to treat infections. The aim of this study was to investigate the antimicrobial efficacy of chamomile extract on the removal of E. faecalis root canal biofilm. Materials and Methods: Chamomile flower extract was prepared and subjected to detailed chemical analysis. For the in vitro biofilm model, human mandibular premolars (n=48) with 18-20mm working length were used. Root canal preparation was performed using the ProTaper® Next system. Each sample was split longitudinally and reassem
... Show MoreThis research means a study (the impact of the Arab-Islamic environment on contemporary painting, the artist Abd al-Rahman al-Suleiman as a model). The research falls into two axes: the first: the theoretical axis, and the second: the applied axis. The first axis dealt with an introduction that contained: (the research problem, its importance, its goal, its limits, and the definition of terms). This research aims to uncover (the impact of the Arab-Islamic environment on contemporary painting, and the artist Suleiman was a model). And the research limits spatially: Saudi Arabia, and temporally: 2010-2014. This theme included two topics: The first: the characteristics of the Saudi environment and its impact on art. The second: the s
... Show MoreBackground: Repeated teenage pregnancy is a major burden on the healthcare system worldwide. Objective: We aimed to compare teenagers with their first and third pregnancies and to evaluate the likelihood of neonatal complications. Materials and Methods: This cross-sectional study was performed on female teenagers (aged ≤ 19 yr) with singleton pregnancies. The subjects (n = 298) were screened over 12 months. Ninety-six women were excluded, based on the exclusion criteria. The remaining subjects (n = 202) were divided into two groups: teenagers with first pregnancy (n = 96) and teenagers with third pregnancy (n = 47). The subjects were observed throughout pregnancy and delivery. The final sample size of the first and thi
... Show More