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 surgery Keywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
One of the scientific education aims, preparing a student able to keep up with the scientific developments and innovations around him and make him contribute, adapt, investment and continue development. The concepts of nanotechnology from scientific innovation open up an important area of thinking and intervention in the field of chemistry applications in daily life, the technological changes lead to social, political and economic changes which result that the students to have the knowledge, understanding, awareness, appreciation and sense in applications of modern technology for their use optimally, in order to cope with these scientific and technological changes. The research aims at finding out the correlation between the acquisi
... Show MoreMulti-belled piles are piles with enlarged ends; these piles have one or further bells at the lower third part of the pile. These piles are suitable for many soils with problems such as softening clay, the variation of groundwater table, expansive soils, black cotton soil, and loose sand. The current study reviewed the behavior of belled piles in multi-layer soils subjected to axial compression and pullout loading. The review covered the experimental and theoretical works on belled piles in multi-layered soils. These piles were subjected to static and dynamic loadings in compression and pullout cases. Most theoretical results focused on software such as PLAXIS 3D. The axial load applied on the piles comes from the upper
... Show MoreThe literature shows conflicting outcomes, making it difficult to determine how e-learning affects the performance of students in higher education. The effect of e-learning was studied and data has been gathered with the utilization of a variety of qualitative and quantitative methods, especially in relation to students' academic achievements and perceptions in higher education, according to literature review that has been drawn from articles published in the past two decades (2000-2020). The development of a sense of community in the on-line environment has been identified to be one of the main difficulties in e-learning education across this whole review. In order to create an efficient online learning community, it could be claim
... Show MoreThe dangerous and potentially blinding condition known as Acanthamoeba keratitis is caused by free-living amoebae of the genus Acanthamoeba. The prevalence of AIDS patients and contact lens wearers has increased in recent years, making cannaeba infections more significant. It's interesting to note that, depending on the parasite, host, and environmental conditions, the pathways linked to Acanthamoeba pathogenesis are frequently extremely complex. Notwithstanding our progress in antibiotic therapy and supportive care, the prevalence of Acanthamoeba keratitis has not decreased
Some genetic factors are not only involved in some autoimmune diseases but also interfere with their treatment, Such as Crohn's disease (CD), Rheumatoid Arthritis (RA), ankylosing spondylitis (AS), and psoriasis (PS). Tumor Necrosis Factor (TNF) is a most important pro-inflammatory cytokine, which has been recognized as a main factor that participates in the pathogenesis and development of autoimmune disorders. Therefore, TNF could be a prospective target for treating these disorders, and many anti-TNF were developed to treat these disorders. Although the high efficacy of many anti-TNF biologic medications, the Patients' clinical responses to the autoimmune treatment showed significant heterogeneity. Two types of TNF receptor (TNFR); 1 an
... Show MoreHealth and safety problem can be described by statistics it can only be understood by knowing and feeling the pain, suffering, and depression. Health and safety has a legal responsibility to protect it for everyone who can affect in the workplace. This includes manufacturers, suppliers, designers and controllers of work places and employees. Work injury is one of the major problems in manufacturing and production systems industries; it is reduced production efficiency and affects the cost. To gain flexibility from a traditional manufacturing system and production efficiency, this paper is about the application of estimating technology to preview and synthesis of Lost Time of Work Injuries in industry systems aims to provide a safe workin
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The research aimed to evaluate the financial performance of the Public Company for the manufacture of medicines and medical supplies / Samarra - Iraq to know the strengths and weaknesses that affect its performance, as well as to compare its performance in the years between (2017-2019), which are characterized by security stability with its performance in previous years (2014 -2016) which is characterized by security instability, to assess the extent of its ability to achieve growth in performance, by answering the main question, what is the evaluation of the performance of the Public Company for the manufacture of medicines and medical supplies / Samarra - Iraq in the light of financial indicators?
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