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.
This paper deals with one of the most important issues in a foreign language teaching and learning, i.e. speaking test assessment. After giving a survey of literature written on the meaning and definition of a speaking test assessment, two sections have been devoted to tackle the most important issues in this topic. Section one, which is the theoretical part of this paper, sheds light on the basic definitions of the term ‘speaking assessment’ which are, according to the researcher’s point of view, sufficient to cover the area of the study. This section based on applied linguistic theories and researches in order to enhance our understanding of the what is meant by «a speaking test assessment«In addition,it explains the most importan
... Show MoreBackground: An accurate adaptation of the crown to the finish line is essential to minimize cement dissolution and to preserve periodontium in fixed partial denture cases. An accurate adaptation of crown is possible only when preparation details are captured adequately in the impression and transferred to cast. For these reasons, gingival displacement is necessary to capture subgingival preparation details.The aim of the present study is to measure in vivo the horizontal displacement of the gingival sulcus obtained by using three new cordless retraction materials (Magic Foam Cord®, Racegel and Astringent Retraction Paste) in comparison to medicated retraction cord. Materials and method: Thirty-two patients requiring porcelain fused to me
... Show MoreThe number of infections caused by microorganisms is increasing significantly over the last few years. A total of 140 patients admitted to the central teaching hospital of pediatrics from the 1st of Jun 2017 to 31 October 2017. The Clinical samples was processed from culture and sensitivity testing. Antibiotic discs used for gram negative isolates. The most prevalent gram negative isolates included Escherichia coli 63 (45.0 %), Pseudomonas spp. 21 (15.0 %), Klebsiella spp. 19 (13.6 %) predominantly. Escherichia coli were the most prevalent isolates from urine 45 (71.4 %), Klebsiella spp. 11 (57.9 %) and Enterobacter spp. 11 (68.8 %) followed by Escherichia coli 10 (15.9 %) predominant from blood. 68 (48.6 %) of specimens were urine, 47 (33.
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Pituitary adenomas are the anterior pituitary tumors. Patients with an Aryl Hydrocarbon Receptor-Interacting Protein (AIP) mutation (AIP- mut) tend to have more aggressive tumors occurring at a younger age. Single nucleotide polymorphisms (SNPs) in many studies have been related to metabolic comorbidities in the general population. Study aims investigated the role of AIP gene SNPs with susceptibility to acromegaly pituitary- adenoma, with levels of LH, FSH, TSH, Testosterone, IGF1,GH, FT4 , Prolactin hormones and blood sugar levels. The study was conducted on a group of acromegaly patients, including 50 patients) both Genders( with hyperplasia of the ends, and apparently healthy control group. Genotyping of
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Background: Glass ionomer restorations are widely employed in the field of pediatric dentistry. There is a constant demand for a durable restoration that remains functional until exfoliation. This study aimed to measure and compare the effect of a novel coating material (EQUIA Forte Coat) on the microleakage of glass hybrid restoration (EQUIA Forte HT) in primary teeth. Material and method: Thirty cavitated (class-II) primary molars were allocated randomly into two groups based on the coat application; uncoated (control) and coated group (experimental). Cavities were prepared by the use of a ceramic bur (CeraBur) and restored with EQUIA Forte HT with or without applying a protective coat (EQUIA Forte Coat). Samples went through the therm
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In this research, the theme for employing a simple and sensitive method is to employ a new Schiff base ligand (N’-(4- (dimethyl amino) benzylidene)-3, 5-dinitrobenzohydrazide) to estimate Ni (II) to form orange complex (N-(4-(dimethyl amino) benzylidene)-3, 5-dinitrobenzohydrazide nickel (II) chloride) in acid medium (hydrochloric acid), it gives an absorption peak at the wavelength 485 nm. The preferred conditions were studied to form the complex and obtain the highest absorbance including concentration of Schiff base ligand, the best medium for complex formation, effects of addition sequence on complex formation, the effect of temperature on the absorbance of the complex formed, and the setting time of the formed complex. The obtained r
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A novel demountable shear connector for precast steel‐concrete composite bridges is presented. The connector uses high‐strength steel bolts, which are fastened to the top flange of the steel beam with the aid of a special locking nut configuration that prevents slip of bolts within their holes. Moreover, the connector promotes accelerated construction and overcomes typical construction tolerances issues of precast structures. Most importantly, the connector allows bridge disassembly, and therefore, can address different bridge deterioration scenarios with minimum disturbance to traffic flow, i.e. (i) precast deck panels can be rapidly uplifted and replaced; (ii) connectors can be rapidly removed and replaced; and (iii) steel beams can b
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