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.
Psychological damage is one of the damages that can be compensated under the fault of negligence in the framework of English law, where the latter intends to include an enumeration of civil errors on the basis of which liability can be determined, and aims under each of these errors to protect a specific interest (for example, defamation protects Among the damage to reputation and inconvenience are the rights contained on the land), and the same is true for the rest of the other errors. Compensation for psychological damage resulting from negligence has raised problems in cases where the psychological injury is "pure", that is, those that are not accompanied by a physical injury, which required subjecting them to special requirements by the
... Show MorePragmatics looked at literary discourse as an external subject that needed an actor and based on a communicative relationship, that is, it examines literary work by focusing on the author's intent, and attempting to monitor the pilgrim and logical dimension in the text. It focuses on the practical and communicative aspect of the language, which aims to convince the recipient and his or her emotional influence.And the novel (Yamrim) starting from the title (Sos) communication, and building dialogue and pilgrims based on two different logic completely, the logic of optimism and look at things with absolute objectivity, the logic of pessimism and closure and look at things with absolute passion. These two tendencies are embodied by the char
... Show MoreAs many expensive and invasive procedures are used for the diagnosis or follow-up of clinical conditions, the measurement of cell-free DNA is a promising, noninvasive method, which considers using blood, follicular fluid, or seminal fluid. This method is used to determine chromosomal abnormalities, genetic disorders, and indicators of some diseases such as polycystic ovary syndrome, pre-eclampsia, and some malignancies. Cell-free DNA, which are DNA fragments outside the nucleus, originates from an apoptotic process. However, to be used as a marker for the previously mentioned diseases is still under investigation. We discuss some aspects of using cell-free DNA measurements as an indicator or marker for pathological conditions.
The current research aims to identify the types and rates and the reasons for the crimes that are with the origin and sexual scattered deviation between the fabric of Iraqi society, which reticent about because of the culture of the community, where he offered a researcher investigator justice and tribal leaders and lawyers about proportion and the types and causes of crime is the origin of sexual deviance and finally a question asked a researcher in 1000 young lived their adolescence days of the former regime (1979-2003) from going to brothels researcher found that 920 people and 92% had gone to the house to practice adultery and that 70 of them, and by 7% had engaged in masturbation only and that 10 of them have not committed anything
... Show MoreObjective: To determine the effectiveness of a dietary educational program upon the hypertensive client’s
information.
Methodology: The sample of the study consists of (60) hypertensive clients who attended Al Anbar Health Office –Al
Andalus Health Center during the period of the study from the14th of March 2010 to the 30th of September 2010. The
sample is divided into two groups; study group (30) hypertensive clients who received dietary educational program
and control group (30) hypertensive clients who received a routine care from the center. Three major instruments
were used; these instruments included (1) knowledge test which was applied on both groups pretest and eight weeks
post-test (2) questions to know
Since the appearance of COVID-19 disease as an epidemic and pandemic disease, many studies are performed to uncover the genetic nature of the newly discovered coronavirus with unique clinical features. The last three human coronavirus outbreaks, SARS-CoV, MERS-CoV and SARS-CoV-2 are caused by Beta-Coronaviruses. Horizontal genetic materials transfer was proven from one coronavirus to the other coronavirus of non-human origin like infectious bronchitis virus (IBV) of avian. Horizontal genetic materials transfer was also from non-corona viruses like astroviruses and equine rhinovirus (ERV-2) or from coronavirus-unrelated viruses, like influenza virus type C. However, SARS-CoV-2 is identical to SARS-CoV and MERS-CoV. Interestingly, Wuhan ci
... Show MoreTwelve species of philodromid crab or running crab spiders (Philodromidae) have been recorded in Armenia. Nine species are new to the spider fauna of this country: Philodromus cespitum (Walckenaer, 1802); Philodromus emarginatus (Schrank, 1803), Philodromus rufus Walckenaer, 1826; Rhysodromus histrio (Latreille, 1819), Thanatus atratus Simon, 1875; Thanatus formicinus (Clerck, 1757); Thanatus imbecillus L. Koch, 1878; Thanatus vulgaris Simon, 1870 and Thanatus pictus L. Koch, 1881.
In this work a novel drug delivery system through modification of poly acrylic acid with Methionine as a spacer between the poly acrylic acid which was converted to its acyl chloride and reacted with Methionine as spacer unit which has been reacted with Ampicillin drug. In vitro drug release study had been conducted successfully in basic medium in pH 7.4 and acidic medium in pH 1.1 at 37?. Due to many problems associated with drug release and, this modification could decrease the side effect of drug. The prepared prodrug polymer was characterized by spectra method [FTIR and 1H?NMR]. Physical properties and intrinsic viscosity of drug polymer were determined. The good results were obtained in the presence of spacer unit with compar
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