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.
Congenital absence of anterior cruciate ligament is highly uncommon occurrence. It has since been documented as a standalone anatomical entity or, more frequently, in conjunction with other congenital anomalies. Surgical treatment for this patient population has only been reported in very few cases. In this article, we share our experience in managing a case of unilateral congenital deficiency of anterior cruciate ligament (ACL) in a 13 years old female patient by physeal sparing arthroscopic ACL reconstruction, using All-inside technique.
Information pollution is regarded as a big problem facing journalists working in the editing section, whereby journalistic materials face such pollution through their way across the editing pyramid. This research is an attempt to define the concept of journalistic information pollution, and what are the causes and sources of this pollution. The research applied the descriptive research method to achieve its objectives. A questionnaire was used to collect data. The findings indicate that journalists are aware of the existence of information pollution in journalism, and this pollution has its causes and resources.
Background: Immediate implant placement in the maxillary anterior region was challenging, especially with the jumping gap and limited primary implant stability. Objective: To assess the autogenous dentin graft biomaterial's ability to improve the esthetic outcomes of an immediately inserted implant. Methods: Twenty patients with non-restorable retained roots in the maxillary non-molar region surrounded by natural sound teeth were included in this study after a complete clinical and radiological examination, including patient health and clinical fitness for the immediate dental implant procedure. A single dental implant was inserted for each patient, and the resulting jump distance was filled with the mineralized dentin graft and co
... Show MoreThe performance of a synergistic combination of electrocoagulation (EC) and electro-oxidation (EO) for oilfield wastewater treatment has been studied. The effect of operative variables such as current density, pH, and electrolyte concentration on the reduction of chemical oxygen demand (COD) was studied and optimized based on Response Surface Methodology (RSM). The results showed that the current density had the highest impact on the COD removal with a contribution of 64.07% while pH, NaCl addition and other interactions affects account for only 34.67%. The optimized operating parameters were a current density of 26.77 mA/cm2 and a pH of 7.6 with no addition of NaCl which results in a COD removal efficiency of 93.43% and a specific energy c
... Show MoreA comparison of double informative and non- informative priors assumed for the parameter of Rayleigh distribution is considered. Three different sets of double priors are included, for a single unknown parameter of Rayleigh distribution. We have assumed three double priors: the square root inverted gamma (SRIG) - the natural conjugate family of priors distribution, the square root inverted gamma – the non-informative distribution, and the natural conjugate family of priors - the non-informative distribution as double priors .The data is generating form three cases from Rayleigh distribution for different samples sizes (small, medium, and large). And Bayes estimators for the parameter is derived under a squared erro
... Show MoreThe study aimed to build a suggested conception for employing gamification in teaching the general education curricula. Using the analytical method of the previous analytical studies in Teaching, which agreed with the determinants of the analysis of 20 studies from 2014 to 2019, they come on order: points, badges, leaderboards, and then levels. The four most commonly used theories are the theory of self-determination, flow theory, the theory of planned behavior and social theory. In addition, the researcher identified the most commonly used models in gamification, respectively: the ARCS model and the user-based design model. Based on the results of the analysis and using the descriptive approach, the researcher presented a practical perc
... Show MoreIn Production and Operations Management the specialists have tried to develop a strategy to counter the risks arising from the activities of the organization and of waste of various types and therefore the risk management in the contemporary framework represents a phenomenon of new quality, and can not be this phenomenon to take practical dimensions, but the development of culture of the organization towards the risks and deal with all aspects and paint ways to address them within an integrated program, and requires new skills and systems provide accurate information capable of coordination between the various parties within the organization.
The research aims to develop a blu
... Show More