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.
Embracing digital technological advancements in media and communication has led government entities to adopt communication practices fully aligned with the digital and networked system in government communication. Traditional media practices within the government environment increasingly rely on the ability to utilize digital tools and systems for content creation, communication, evaluation, and the management of the entire communication process within an electronic and intelligent framework for government services. Naturally, this transformation has caught the attention of communication and public relations researchers worldwide, as the digital and networked aspects of government communication now form an intelle
... Show MoreSkin drug administration is the method used to provide drugs for local or systemic therapy, which is recognized for clinical usage. It is the third-largest method of medication delivery, after only intravenous administration and oral administration. Using a transdermal delivery method makes the administration easy, and blood concentration and adverse effects can be reduced. A microneedle is a micron-sized needle with a short height of no more than 500 micrometers and a width of no more than 50 micrometers. The needle comes into contact with the epidermal layer of the skin before it gets to the dermal layer, where there is no discomfort. Several materials, such as metals, inorganic, and polymer materials, are used to create microneed
... Show MoreThe aim of this study is to shed light on the importance of biofuels as an alternative to conventional energy, in addition to the importance of preserving agricultural crops, which are the main source of this fuel, to maintain food security, especially in developing countries. The increase in global oil prices, in addition to the fear of global warming, are among the main factors that draw the world’s attention to searching for alternative sources of traditional energy, which are sustainable on the one hand, and on the other hand reduce carbon emissions. Therefore, the volume of global investment in renewable energy in general, and in liquid biofuels and biomass in particular, has increased. Global fears emerged that the excessive convers
... Show MoreThe aim of this study is to shed light on the importance of biofuels as an alternative to conventional energy, in addition to the importance of preserving agricultural crops, which are the main source of this fuel, to maintain food security, especially in developing countries. The increase in global oil prices, in addition to the fear of global warming, are among the main factors that draw the world’s attention to searching for alternative sources of traditional energy, which are sustainable on the one hand, and on the other hand reduce carbon emissions. Therefore, the volume of global investment in renewable energy in general, and in liquid biofuels and biomass in particular, has increased. Global fears emerged that the excessive
... Show MoreDeveloping an efficient algorithm for automated Magnetic Resonance Imaging (MRI) segmentation to characterize tumor abnormalities in an accurate and reproducible manner is ever demanding. This paper presents an overview of the recent development and challenges of the energy minimizing active contour segmentation model called snake for the MRI. This model is successfully used in contour detection for object recognition, computer vision and graphics as well as biomedical image processing including X-ray, MRI and Ultrasound images. Snakes being deformable well-defined curves in the image domain can move under the influence of internal forces and external forces are subsequently derived from the image data. We underscore a critical appraisal
... Show MorePurpose: The study aims to investigate the extent to which material and non-material requirements are available in applying budgeting programs and performance in Iraqi governmental companies that are not aimed at achieving profits. whose activities are limited to providing services of public interest. This is done by studying the extent to which the requirements of each stage of preparing the programs and performance budget can be met. Theoretical framework: The process of evaluating financial performance is the main objective of all economic units, whether they are governmental or private economic units. Budgets contribute to the evaluation process by analyzing deviations in the application. The study includes an analytical pres
... Show MoreLow back pain a major causes of morbidity throughout the world and it is a most debilitating condition ,and can lead to decreased physical function ,compromised quality of life, and psychological distress.
Obesity is nowadays a pandemic condition. Obese subjects are commonly characterized by musculoskeletal disorders and particularly by non-specific LBP. However, the relationship between obesity and LBP remain to date unsupported by objective measurements of mechanical behavior of spine and it is morphology in obese subjects. &nb
... Show MoreAmygdalin (d-Mandelonitrile 6-O-β-d-glucosido-β-d-glucoside) and its semi synthetic product is Laetrile ( also called vitamin B17): a natural cyanogenic glycoside occurring in the seeds of some edible plants, such as bitter almonds and peaches. Early in the 19th century, Amygdalin was first isolated in 1830 by two French chemists, Robiquet and Boutron-Charlard, as active components in various fruit pits and raw nuts. However, the systematized study of vitamin B17 started when chemist Bohn (1802) discovered that a hydrocyanic acid is released during distillation of the water from bitter almonds. The various pharmacological effects of Laetrile include antiatherogenic, activity in renal fibrosis, pulmonary fibrosis, immune regulation, ant
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