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.
Abstract
Among the things that have happened and that have emerged from the developments in society is the phenomenon of dairy banks, where institutions collect milk from donating mothers or sellers of milk and benefit from it by sterilizing and selling it.
This topic is considered one of the important topics, as Islam considers breastfeeding as a link as well as parentage, and it has the same genealogy as the spread of sanctity. Therefore, Imamate jurists addressed this topic with research despite its absence in Islamic societies.
The importance of r
... Show MoreThere are still areas around the world suffer from severe shortage of freshwater supplies. Desalination technologies are not widely used due to their high energy usage, cost, and environmental damaging effects. In this study, a mathematical model of single-bed adsorption desalination system using silica gel-water as working pair is developed and validated via earlier experiments. A very good match between the model predictions and the experimental results is recorded. The objective is to reveal the factors affecting the productivity of fresh water and cooling effect in the solar adsorption system. The proposed model is setup for solving within the commercially-available software (Engineering Equation Solver). It is implemented to so
... Show MoreThe research problem is to determine the nature of the historical relationship between the profession of social work and volunteer work. Consequently, the research aims to investigate the nature of this relationship from a socio-historical perspective. Three axes have been used to analyze this relationship: the role of voluntary work in the development of the social work as a profession, the efforts made by social work to reach professionism and to distinguish it from voluntary work, and the relationship between social work and voluntary work. The research is qualitative analytical research and adopts the Mixed Methods Research (MMR). It identifies some literature for the analysis and implementation of a scoping process. It represents a
... Show MoreThe experiment was aimed to evaluate a locally manufactured a dual-action device used for measuring feed pellets durability. The device performs dropping process in conventional devices, then sifting process to separate the pellets from the crumbles simultaneously, with a control the motor speed by using the pulse width modulation (PWM) Technique. The device performance was compared with the durability measuring device of a moving drop box. Rotational speed, diameter of the die holes of the machine was used in this study. The results showed that increasing the rotational speed of the die from 280 to 300 and to 320 rpm, increasing the die holes diameter from 3 to 4 and to 5 mm, led to
Enamel White Spot Lesions (EWSLs) are a common dental condition characterized by being opaque or chalky white in appearance. In this review, an overview of the etiology, prevention, and treatment techniques for EWSLs is presented. Enamel demineralization caused by bacteria in dental plaque which releases acids upon the consumption of fermentable carbohydrates causing mineral loss is thought to be the main cause of those lesions, which could be predisposed through orthodontic treatment, poor diet, inadequate oral hygiene and certain medical conditions. So, sustaining an adequate carbohydrate consumption, proper fluoride exposure and good oral hygiene are some of the practices which aid in these lesions’ prevention. Although the suc
... Show MoreThis research provides a new method to study praise poetry that can be used as a course to teach English and Arabic to students in the College of Education. This research answers two questions: Is it possible to examine praise poetry as a tagmeme? Is this analysis of great help in teaching English and Arabic to students in the College of Education? The data that will be chosen for the purpose of analysis are two of Shakespeare's sonnets and two of AL Mulik's poems. The sonnets selected for this purpose are 17 and 18. AL Mulik's poems selected for the same purpose are 8 and 9. Each line in both English and Arabic data is numbered by the researcher herself. Then, those lines are grouped into sentences to facilitat
... Show MoreCarbazone Derivatives (CD) (semicarbazone, semithiocarbasone) are produced by the condensation reaction between a aldehyde (or ketone) with a carbazide derivatives (semicarbazide, semithiocarbazide). CD and their metal complexes existent a wide range of implementation that stretch from their ply in the medicinal and pharmaceutical area because of their major significant pharmacological characteristic such as anti-fungal,anti-bacterial, anti-cancer, anti-human immunodeficiency virus, anti-inflammation, anti-neoplastic,inhibition corrosion, antioxidation, antiradical. This paper reviews the definition, importance and various applications of carbazone derivatives with transitional meta
The textbook is the primary means of creativity and thinking, which has a major role in the development of the readership and mental abilities of the student. It is the basic tool in education in Iraq for the teacher and the student, which cannot be dispensed in any educational program. The current study aimed at the book of the biology of the sixth grade of science in Iraq (comparative study). It was compared to the book of biology for the twelve grade in the Kingdom of Jordan to identify the ratio of similarity and differences between them, in addition, to identify the weaknesses in the Iraq curriculum and developing appropriate solutions and suggestions to address them. The sample was represented with books of biology (six-science cla
... Show MoreBee keping projects is one of the most important agricltural investment projects because it generate profit in a short period . In addition to the multiplicity of products and other benefits . Research aimed at study the feasibility of two projects one hand in the origin of the Al – Mashrok since 2006 , kicking off with ten hives , and the scond proposal , kicking of 100 hives using the criteria of the world bank . Results showed that the bee keeping projects is economically feasible, whether small or large .. Even when the analysis of the sensitivity of the project to changes which may occur in the price of output and resources by reducing costs and increasing revenues by 10% it remains economically viable .
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