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.
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Abstract
This study talks about a wonderful Qur'anic style. relates to one of the methods used in it. And it's the rhetorical style: ''Affirmative say''. It is useful in arguing with the opponent, nullifying his reasoning, and proving the opposite meaning of the opponent. The study will be conducted from a Qur'anic perspective based on the study of examples of it, and partly in interpretive treatment through the book of editing and enlightenment of Taher Ibn Ashour, known for his art in matters of rhetoric and methods of controversy. This is with the rooting of this issue, and the relationship of industrial sciences to it as a Qur'anic style.
Keywords: ''Affirmative say, style, Qur'anic rhetoric, Arabic rhetoric, Co
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The current research aims to identify the role of family upbringing methods in shaping adolescent gender identity disorder, to identify the causes, components, and disorders of the gender identity of adolescents, and to develop practical visions and suggestions to reduce and stop gender identity disorder completely. Due to the sensitivity of the topic, a questionnaire of five open-ended questions was posted on Facebook to collect the needed data, where (20) respondents answered these questions. The researcher took these (20) respondents as the study sample. The results revealed that excessive emancipation within the family, failure to employ family protection laws, and failure to monitor and follow up on
... Show MoreObjective(s): To assess the behavior that impedes the eating of children with autism spectrum disorders in Baghdad city, and find out the relationships between the behaviors that impede eating of autistic children and their demographic characteristics.
Methodology: The study started from the period of 16th September 2019 to the 16th of March 2020. A non-probability (purposive) sample of 80 children with autism spectrum disorders was selected. The questionnaire was designed and composed of two parts: the first part includes the autistic children demographic data, the second part includes scales of behavior that impede eating followed by parents towards autistic child. The reliability of the questionnaire was determined through a pilot
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Science is linked to each other bonds assets, branches and even close to each other; to become a link of this type of patterns of scientific integration, and perhaps the most prominent science that saw the overlap and interdependence of science and jurisprudence and its origins, and this interdependence did not stop at the epistemological foundations of knowledge; To the branches, methods of extraction, and diligence to extend to the terminology; to find similar terms in both flags; to become those terms similar in the word and meaning and even the end, but we do not lack terms similar in pronunciation and differing in meaning; and this difference is imposed by the specificity of each science and what M E; however, approached many terms
... Show MoreThe rapid development of telemedicine services and the requirements for exchanging medical information between physicians, consultants, and health institutions have made the protection of patients’ information an important priority for any future e-health system. The protection of medical information, including the cover (i.e. medical image), has a specificity that slightly differs from the requirements for protecting other information. It is necessary to preserve the cover greatly due to its importance on the reception side as medical staff use this information to provide a diagnosis to save a patient's life. If the cover is tampered with, this leads to failure in achieving the goal of telemedicine. Therefore, this work provides an in
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Secure storage of confidential medical information is critical to healthcare organizations seeking to protect patient's privacy and comply with regulatory requirements. This paper presents a new scheme for secure storage of medical data using Chaskey cryptography and blockchain technology. The system uses Chaskey encryption to ensure integrity and confidentiality of medical data, blockchain technology to provide a scalable and decentralized storage solution. The system also uses Bflow segmentation and vertical segmentation technologies to enhance scalability and manage the stored data. In addition, the system uses smart contracts to enforce access control policies and other security measures. The description of the system detailing and p
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Effects of Ozonated Water on Micro Leakage between Enamel and Fissure Sealants Prepared by Different Etching Technique (An in vitro Study), Baraa M Jabar*, Muna S Khalaf
عند إطلالتنا على هذا البلد العربي لابد من التقصي ولو بعجاله عن اقتصاده وهو الاهم باعتبار ان الاقتصاد هو شريان الحياة لأي أمة فلا غنى ولا تهاون في نفس الوقت عن هذا الجانب المهم الذي يرتبط مدى تطوره بتطور البلد وهذا الاخير مرتبط بما متوفر لديه من موارد بشريه ومادية وان تفاوتت النسبة بينها فلا ضير في ذلك فالاهم هو وجود الموجه والمخطط بالاتجاه الصحيح نحو الاستغلال الامثل لهذه الموارد
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