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.
Apart from graduating five-star doctors, a particular medical college has the mission to motivate and offer researchers the opportunity to publish high-quality researches on various health problems and disseminate updated medical knowledge to a wide range of local and international readers. This could be accomplished by establishing a medical journal and releasing issues regularly
Abstract
Objective(s): To evaluate housekeeping services staff work environment and their health status, as well as to determine the impact of the work environment upon their health status.
Methodology: A descriptive design is employed throughout the present study to evaluate housekeeping services staff work environment and their health status, as well as to determine the impact of the work environment upon their health status from November 3rd 2017 to June 30th 2018. A purposive “nonprobability” sample of (101) housekeeping staff is selected for the present study. An instrument is constructed for the purpose of the study and it is consists of (2) parts: (I) Evaluation of work environment, and (II) Evaluation of housekeeping st
Objective: The objectives of the present study were to evaluate the effectiveness of the instructional intervention
about medical and health knowledge of patients with diabetes mellitus type II.
Methodology: A Quasi- experimental study was carried out in National Center for Diabetes Mellitus/ Almustansria
University, started from 4th January 2012, to 1st April 2012. Non-probability (purposive sample) of (50) diabetes
mellitus type II, who visit National Center for Diabetes Mellitus/ Almustansria University. The study sample is
divided equally into (25) study and (25) control groups. The study group received the instructional intervention.
While the control not exposed to the instructional intervention. The data are coll
This research aims at to identify the extent to which creative thinking skills Impact the change &development of Administrative Leadership styles In Administrative Leadership of the Medical City Department. Identify the nature of the relationship between them, determine the prevailing leadership style, &measure the level of creative thinking skills they have. In order to achieve the objectives of the research, the descriptive analytical method was adopted.
The research tool consisted of a questionnaire consisting of (61) paragraphs, in addition to the interview & observation. The research sample consisted of (170) administrative leaders in the upper &middle organizational levels. The
... Show MoreGiven the importance of ecology and its entry into various fields in general and the urban environment particularly; ecological cities take wide ranges of application at multiple regional and global levels. However, it repeatedly noted that there was a state of cognitive confusion and overlapping in the term ecology comes from the diversity of implementation within several disciplines. Architects, designers, and planners have instilled biological development directly into the formal principles as well as the social structures of the ecological cities. Therefore, the research presents a rapid review of the most relevant areas that dealt with the ecological cities by research and analysis at various levels, from the concept and definition of
... Show MoreLanguage mirrors understanding of the same or other culture. Meaning is hardly encoded in the world community. Some linguists cannot solve language problems because of its abstractedness. Language communicators learn the second or foreign language at schools for three reasons. First, English is not their first language. Second, they have little or no educational background in experiencing what they know in another language. Third, they have not improved their communication skills in English. Analyzing the language as a mean of communication would not be learned enough without its practice. This paper gives an exclusive preview of applied linguistics. It defines the conversion of different areas of the study of language with second o
... Show MorePreserving and saving energy have never been more important, thus the requirement for more effective and efficient heat exchangers has never been more important. However, in order to pave the way for the proposal of a truly efficient technique, there is a need to understand the shortcomings and strengths of various aspects of heat transfer techniques. This review aims to systematically identify these characteristics two of the most popular passive heat transfer techniques: nanofluids and helically coiled tubes. The review indicated that nanoparticles improve thermal conductivity of base fluid and that the nanoparticle size, as well as the concentrations of the nanoparticles plays a major role in the effectiveness of the nanofluids.
... Show MoreGiven the importance of ecology and its entry into various fields in general and the urban environment particularly; ecological cities take wide ranges of application at multiple regional and global levels. However, it repeatedly noted that there was a state of cognitive confusion and overlapping in the term ecology comes from the diversity of implementation within several disciplines. Architects, designers, and planners have instilled biological development directly into the formal principles as well as the social structures of the ecological cities. Therefore, the research presents a rapid review of the most relevant areas that dealt with the ecological cities by research and analys