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.
Interface bonding between asphalt layers has been a topic of international investigation over the last thirty years. In this condition, a number of researchers have made their own techniques and used them to examine the characteristics of pavement interfaces. It is obvious that test findings won't always be comparable to the lack of a globally standard methodology for interface bonding. Also, several kinds of research have shown that factors like temperature, loading conditions, materials, and others have an impact on surface qualities. This study aims to solve this problem by thoroughly investigating interface bond testing that might serve as a basis for a uniform strategy. First, a general explanation of how the bonding strength
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Interface bonding between asphalt layers has been a topic of international investigation over the last thirty years. In this condition, a number of researchers have made their own techniques and used them to examine the characteristics of pavement interfaces. It is obvious that test findings won't always be comparable to the lack of a globally standard methodology for interface bonding. Also, several kinds of research have shown that factors like temperature, loading conditions, materials, and others have an impact on surface qualities. This study aims to solve this problem by thoroughly investigating interface bond testing that might serve as a basis for a uniform strategy. First, a general explanation of how
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Isthmus life and prepare for it
The research aimed at identifying the level of Acute stress disorder and orientation towards supplication among the wives of the martyrs and knowledge of the two levels according to the age groups, academic achievement and profession. Sample of (72) wife of a martyr, and the results of the research indicated that the wives of the martyrs have symptoms of distress disorder and have adherence to the supplication to alleviate that disorder, as well as the results indicated that there are statistical differences in distress disturbance according to the variable of age groups, the profession variable and the variable of enrollment The academic year. As for the measure of the trend towards supplication, there are no statistical dif
... Show MoreTumor necrosis factor-alpha (TNF-α) antagonists’ therapy are expensive and has a non-responsive rate between 30% to 40% in rheumatoid arthritis patients. Genetic variation plays a vital role in the responsiveness to this type of therapy.The aim of this study is to investigate if the presence of genetic polymorphism in the TNF-α gene promoter region at locations -376 G/A (rs1800750), -806 C/T (rs4248158), and -1031 T/C (rs1799964) affects rheumatoid arthritis patient's tendency to be a non-responder to etanercept.
Eighty RA patients on etanercept (ETN) for at least six months were recruited from the Rheumatology Unit at Baghdad Teaching Hospital. Based on The European League Against Rheumatism response (EULAR) criteria, patient
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Introduction : Astrocytomas are the most common primary tumor of the central nervous system,the distinction between them relies mainly on both genetic and histological criteria. However, diagnosis absolutely based on histology has a high interobserver variations and remains problematic even for an experienced neurological pathologist. The objective of this study: To assess the immunohistochemical expression of Ki67 as proliferative markers to study proliferative activity and CD31 as an endothelial cell marker for the sake of studying vascular proliferation in astrocytomas interrelated with some clinicopathological parameters (age, gender, site of the tumor, and tumor grade) in Iraqi patients, will aid in identifying the prognosis for pat
... Show MoreThe bandwidth requirements of the telecommunication network users increased rapidly during the last decades. Optical access technologies must provide the bandwidth demand for each user.The passive optical
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The objective of this study is to evaluate the efficacy and safety of rowatinex and tamsulosin in the treatment of patients with ureteric stone.
Forty patients with ureteric stone ranged (4- 12) mm, were included in this study. They were randomized into two groups where the first group includes twenty patients treated with Rowatinex three times daily (Group 1), and the second group includes twenty patients treated with tamsulosin 0.4mg/day (Group 2). All patients were randomly assigned to receive the designed standard medical therapy for a maximum of 3 weeks.
Each group was given an antibiotic as prophylaxis and an injectable non-steroidal anti-inflammatory drug used on demand. At the outpatient clinic all subjects were a
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