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.
Freedom of opinion and expression occupy the first place among the concerns of countries and international organizations. And it is also the basis of contemporary freedom because it is the foundation for achieving freedom in other fields such as politics, economics, education, etc.. The constitutions of the state have ensured that almost the entire freedom to express an opinion in all its forms either orally or writing or images of expressions, but these freedoms are identified within the law. Most countries announced their commitment to the international conventions and texts issued by international and regional organization like the Universal Declaration of Human Rights in 1948, and the International Covenant on Civil and Political Rig
... Show MoreThe study aimed to determine the impact of energy for the north and south magnetic poles on the the growth of bacteria isolated from cases of tooth decay, 68 swabs were collected from surfaces of faulty tooth, the detected of Staphylococcus aureus
... Show MoreObjective: to evaluate the results of (Modification of Russe method) in treatment of nonunion fracture scaphoid bone by bone graft with external splintage (plaster of paris cast (pop ).
Methods:Prospective study done on 26 patients (24 male, 2 female), age range between 25-42 years (mean age 34 years), fracture site at middle 1/3 with minimal displacements with no carpal bone or radial bone injury, technique of Matte- Russe method (explore the bone through volar approach using bone graft from iliac crest (cortico-cancellous peg plus cancellus bone) with thumb spica for 90 days with period of follow up 12-18 months.
Results: out of 26 patients treated by this method , 23 patients (88.5%) union was achieved radiologically by the end
The modern teaching methods, and their importance in achieving the desired learning goals for the individual and the society, have been addressed, as it is necessary to develop the methods, ways and strategies used in the process of teaching the intermediate stages in the various fields in general and the field of physical education in particular, the importance of research is the effect of using the strategy of similarities in teaching some basic skills of basketball for students of the second intermediate. As for the problem of research, the researcher mentioned the lack of use of teachers’ strategy method similarities in the educational units because of its importance, and after study and analysis the researcher found it necessary to i
... Show MoreSamuel Beckett’s Happy Days (1961) clearly portrays a lack of communication among the characters of the play which refers to the condition of modern man. This failure of communication led Samuel Beckett to use a lot of pauses and silences in all plays written instead of using words. To express the bewilderment of the modern man during the 20th century, Beckett adopts the use of no language strategy in the dramatic works. After World War II, people were without hope, religion, food, jobs, homes, or even countries. Beckett gave them a voice. He used a dramatic language out of everyday things, in which silence was part of the syntax as a poetic repetition. Language is no more important to the modern man; instead, he us
... Show MoreIn this work Polyynes was synthesized by pulse laser ablation of graphite target in ethanol solution. UV-Visible Spectrophotometer, Fourier Transform Infrared Spectroscopy (FTIR) and Transmission electron microscopy (TEM) were used to study the optical absorption, chemical bonding, particle size and the morphology. UV absorption peaks coincide with the electronic transitions corresponding to linear hydrogen – capped polyyne (Cn+1H2), the absorption peaks intensity increased when the polyynes were produced at different laser energies and the formation rats of polyynes increased with the increasing of laser pulse number. The FTIR absorption peak at 2368.4 cm-1, 1640.0 cm-1 and 1276.
... Show MoreTechnology developed at very rapid paces in the last decade of the twentieth century and what followed, especially communication technology, as the World Wide Web appeared in the mid-nineties of the last century, Facebook in 2004 and 2006, the mobile phone, 1993, 1994, and social networking sites. The other. These technological developments have had an impact on societies, whether among individuals in one country or among different peoples. The citizen in any part of the world has become a journalist who practices the work of a specialized or professional journalist, even if he does not know how to read and write, or has a low level of education, as he can now transmit events from wherever he is to the world, through his personal page, or v
... Show MoreNowadays, university education stands in front of both students who feel they are weak and teachers who are addicted to using traditional and dependent teaching. This has led to have negative repercussions on the learner from different aspects, including the mental aspect and the academic achievement process. Therefore, the present research is concerned with finding a new teaching method that adopts the motivation by the fear of failure technique. Thus, the study aims to examine the effect of adopting this method on students’ academic achievement. To achieve this aim, an experimental method was used, and an achievement test was built for the curriculum material of level two students. The pretest test was applied on 17 male and female s
... Show MoreThere is no doubt that Jane Austen is one of the most studied authors of the late 18th and early 19th centuries. Her female characters have been extensively studied and they seem to have aroused much interest as manifestations of the conduct of their time. Her heroines have realized that there were many mistakes in the rules of conduct that controlled and restricted their behaviors. Thus, they have found no fault in correcting these mistakes, by behaving naturally without acting. Elizabeth Bennet the heroine of Pride and Prejudice and Marianne Dashwood of Sense and Sensibility are the chosen examples of that kind of women.
The principle in the language is that each word has one meaning. This is because the purpose of language development is for understanding, understanding, and communication between people. The language is sounds with which each people expresses their Arabic language did not stop at this point, but rather needed another next stage or to convey additional features or characteristics that would qualify it. To be the language of the Qur’an and revelation, and capable of carrying this heavy burden.