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.
The issue of nuclear proliferation is one of the most vital issues as it reflects a form of dealing in the field of international relations. Therefore, the Middle East region has taken great interest in reducing the levels of nuclear armament and acquiring nuclear power within the strategic framework of the international and regional powers. The establishment of a nuclear-weapon-free zone in the Middle East region is currently one of the most important international and regional arrangements for controlling the levels of nuclear proliferation and attempting to build a state of stability and balance. In the Middle East and the world. The importance of the research comes from the fact that it deals with an important and vital issue
... Show MoreUrbanization led to significant changes in the properties of the land surface. That appends additional heat loads at the city, which threaten comfort and health of people. There is unclear understanding represent of the relationship between climate indicators and the features of the early virtual urban design. The research focused on simulation capability, and the affect in urban microclimate. It is assumed that the adoption of certain scenarios and strategies to mitigate the intensity of the UHI leads to the improvement of the local climate and reduce the impact of global warming. The aim is to show on the UHI methods simulation and the programs that supporting simulation and mitigate the effect UHI. UHI reviewed has been conducted the for
... Show MoreBackground: Oral health is an essential component of nursing care, and the maintenance of oral health, through both pharmacological and non-pharmacological management, is widely employed in clinical practice to support effective oral care. In children, oral health plays a crucial role in overall wellbeing, and nurses are often among the first healthcare professionals to identify, address, and prevent oral health problems. Objectives: This narrative review synthesizes and analyzes the historical evolution and available evidence regarding the nursing role in managing oral health in children, with a specific focus on nurse-led practices. It explores how nurses contribute to prevention, early detection, education, and the implementation
... Show MoreThe current research deals with practical studies that explain to the Iraqi consumer multiple instances about the phenomenon of water hammer which occur in the water pipeline operating with pressure. It concern a practical study of the characteristics of this phenomenon and economically harmful to the consumer the same time. Multiple pipe fittings are used aimed to reduce this phenomenon and its work as alternatives to the manufactured arresters that used to avoid water hammer in the sanitary installations, while the consumer did not have any knowledge as to the non-traded for many reasons, including the water pressure decreases in the networks and the use of consumer pumps to draw water directly from the network. Study found a numbe
... Show MoreIntroduction: All-ceramic crowns are widely used in prosthodontics and cosmetic dentistry due to their good esthetic and proper physical properties. Chipping of ceramic is one of the most common post-insertion complications, that can be fixed either extraoral or intraorally. The latter is time time-effective alternative, less traumatic, and low-cost. A newer objective method of laser is a surface modification of ceramics to increase surface roughness. The aim of this study is to provide a review of Er,Cr;YSGG (2960nm) in intraoral repair and shear bond strength (SBS). Method: A thorough search considering Google Scholar and PubMed published data and ten articles found wh
... Show MoreThe current research deals with practical studies that explain to the Iraqi consumer multiple instances about the phenomenon of water hammer which occur in the water pipeline operating with pressure. It concern a practical study of the characteristics of this phenomenon and economically harmful to the consumer the same time. Multiple pipe fittings are used aimed to reduce this phenomenon and its work as alternatives to the manufactured arresters that used to avoid water hammer in the sanitary installations, while the consumer did not have any knowledge as to the non-traded for many reasons, including the water pressure decreases in the networks and the use of consumer pumps to draw water directly from the network. Study found a number of
... Show MorePhysical measurements are one of the basic factors that affect the performance of the goalkeeper, especially when confronting fixed kicks that require special skills such as the reaction and accuracy in concentration, and with technological development artificial intelligence has become an effective tool for analyzing mathematical data that is difficult to discover in traditional methods The study aims to employ techniques Artificial intelligence to study the relationship between physical measurements and the accuracy of confronting the fixed kicks of goalkeepers in football. This study will contribute to providing a deeper understanding of physical factors that affect the performance of goalkeepers, in addition to designing dedicat
... Show MoreA large number of natural or synthetic dyes have been removed from both national and international lists of permitted food colors because of their mutagenic or carcinogenic activity. Therefore, this study aimed to use the Random Amplified Polymorphic DNA-Based Polymerase Chain Reaction (RAPD-PCR) assay as a feasible method to evaluate the ability of some food colors as genotoxin-induced DNA damage and mutations. Lactiplantibacillus plantarum was used as a bioindicator to determine the genotoxic effects by RAPD-PCR using M13 primer after treatment with some synthetic dyes currently used as food color additives, including Sunset Yellow, Carmoisine, and Tartrazine. Besides qualitative analysis, the bioinformatic GelJ software was used for clus
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