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.
Tumor 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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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
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The Child is the first sedum for the human society performing, and we deal in our
research to explain the nature of the mutual relations in between the form and the medicine
social caring foundation. So the motherhood and the childhood nowadays become the most
dedicated in the researchers works, whom interesting in the social affairs, and that whom
work in the medicine field as scientists.
So the child is the future man and must be in wright body construction that need to great
care and interest to make him wright mind through capability of performing anything support
to him.
In our research we deal with the main factors in which lead to infect the child by the
creative malfunction, like the environmental and m
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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Abstract
This study talks about a wonderful Qur'anic style. relates to one of the methods used in it. And it's the rhetorical style: ''Affirmative say''. It is useful in arguing with the opponent, nullifying his reasoning, and proving the opposite meaning of the opponent. The study will be conducted from a Qur'anic perspective based on the study of examples of it, and partly in interpretive treatment through the book of editing and enlightenment of Taher Ibn Ashour, known for his art in matters of rhetoric and methods of controversy. This is with the rooting of this issue, and the relationship of industrial sciences to it as a Qur'anic style.
Keywords: ''Affirmative say, style, Qur'anic rhetoric, Arabic rhetoric, Co
... Show MorePoetic objects may go towards a specific purpose and dissolve and interact with them to produce
A purpose characterized by the title but belongs to the U from afar.
The yarn goes towards praise with a purely horizontal relationship that mentions virtues but crowns them towards women.
In lamentation remember the virtues but crown them towards the dead.
In wisdom remember the virtues but crown them towards time.
In the description remember the virtues but crown them towards nature. All objects are inline
Horizontal We will prove this in the axes of research has required the plan to be a blind, five
The preamble, a brief overview of the life of Dabal All Khuzaie and the works and poets of the first axis
The direction