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 surgeryKeywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
The inflammatory response is a crucial aspect of the tissues’ responses to deleterious inflammogens. This complex response involves leukocytes cells such as macrophages, neutrophils, and lymphocytes, also known as inflammatory cells. In response to the inflammatory process, these cells release specialized substances which include vasoactive amines and peptides, eicosanoids, proinflammatory cytokines, and acute-phase proteins, which mediate the inflammatory process by preventing further tissue damage and ultimately resulting in healing and restoration of tissue function. This review discusses the role of the inflammatory cells as well as their by-products in the mediation of inflammatory process. A brief insight into the role of natural an
... Show MoreEpithelial mesenchymal transition (EMT) is a process comprising cellular and molecular events which result in cells shifting from an epithelial to a mesenchymal phenotype. Periodontitis is a destructive chronic disease of the periodontium initiated in response to a dysbiotic microbiome, and dominated by Gram-negative bacteria in the subgingival niches accompanied by an aberrant immune response in susceptible subjects. Both EMT and periodontitis share common risk factors and drivers, including Gram-negative bacteria, excess inflammatory cytokine production, smoking, oxidative stress and diabetes mellitus. In addition, periodontitis is characterized by down-regulation of key epithelial markers such as E-cadherin together with up-regulation of
... Show MoreRobots have become an essential part of modern industries in welding departments to increase the accuracy and rate of production. The intelligent detection of welding line edges to start the weld in a proper position is very important. This work introduces a new approach using image processing to detect welding lines by tracking the edges of plates according to the required speed by three degrees of a freedom robotic arm. The two different algorithms achieved in the developed approach are the edge detection and top-hat transformation. An adaptive neuro-fuzzy inference system ANFIS was used to choose the best forward and inverse kinematics of the robot. MIG welding at the end-effector was applied as a tool in this system, and the wel
... Show MoreThe European continent suffers from the presence of some separatist tendencies,the effect of racial and ethnic variables driving the crystallization of separatist conflicts, led to the success of some of them in establishing sovereign states, while the other failed to achieve this. The research focused on the importance of matching geographical, cultural and political criteria in the success of separatist tendencies.It also focused on the role of policies imposed by the mother country in curbing or exacerbating the separatist trend, during the level of fairness in the distribution of wealth between the regions, what were the rights and duties of those persecuted and battered minorities. Therefore, the research focused on presenting a
... Show MoreThe present study aimed to asspssment the nutrition a program to sample of student from internal departments of Baghdad University (AL-Jadiriya Complex) and the University of AL-MustanSiriya four grades and aged (19-24) year study included 150 male and female students by (75) male and (75) of female register height, weight nd body mass index were study habits and food pattern of the same sample (150) and by aspecial form and take the personal information interviews and record information on food intake during 24 hour .noted adifference practie in the weights and longths of male and female (sample).
BMI rates were within the normal weight as the value of BMI for males aged (19- 21)and (22-24) and (22.21) and (23,37),respectively and th
Foreign body embolization is a rare but serious iatrogenic complication that might necessitate transcatheter or even surgical retrieval. A broken double-lumen catheter was snared using a goose neck snare kit. The procedure was successful, and the patient experienced no further complications.
Purpose - This study relies on the descriptive and analytical approach through collecting and analyzing the necessary data, as this approach focuses on polling the opinions of the research sample and its directions, and aims to develop a model that studies the relationship between knowledge creation and organizational ambidexterity in Iraqi private banks and verifying its validity experimentally. Design / Methodology / Introduction - A survey was conducted through a questionnaire form to collect data from a sample of (113) managers in private commercial banks. In addition, this study used the AMOS program and the ready-to-use statistical program package (SPSS V.25) to test the proposed hypotheses of the theoretical model experimentally. Res
... Show MoreNowadays, most of the on-chip plasmonic single-photon sources emit an unpolarized stream of single photons that demand a subsequent polarizer stage in a practical quantum cryptography system. In this paper, we numerically demonstrated the coupling of the light emitted from a quantum emitter (QE) at 700 nm wavelength to the propagation mode supported by an on-chip hybrid plasmonic waveguide (HPW) polarization rotator. Our results proved that the light emitted is linearly polarized at 0º, 45º/−45º, and 90º with propagation lengths of 5 μm, 3.3 μm, and 3.9 μm, respectively. Moreover, high power-conversion efficiency was obtained from an applied transverse magnetic (TM) mode (0º-polarization) to a transverse electric (TE) (90º-polari
... Show MoreThe research topic was chosen as a result of the importance of human resource in business organizations in general and the industrial process in particular. Without the human resource, business organizations cannot continue and achieve success and excellence, and the research problem has been diagnosed in the lack of sales of General Cement Company’s northern products, despite their distinctiveness, standing, and reputation in The market and its products with standard specifications, and through this problem, the following questions were raised: &nbs
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