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.
Since the time it emerged, stylistics, as a field of knowledge which combines both linguistics and literature, acquired a special status in the linguistic arena. Its significance in complementing the meaning delivered by linguistic means has been proven and acknowledged through numerous stylistic analytic attempts of different literary works and in different languages. The question put forward in this paper is whether or not the stylistic analysis can work as effectively on translated texts as it does on the original ones without having the results reached by the analysis distorting the meaning of the original text. An attempt to investigate this question is made herein by conducting a lexical stylistic analysi
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The aerodynamic characteristics of the forward swept wing aircraft have been studied theoretically and experimentally. Low order panel method with the Dirichlet boundary condition have been used to solve the case of the steady, inviscid and compressible flow. Experimentally, a model was manufactured from wood to carry out the tests. The primary objective of the experimental work was the measurements of the wake dimensions and orientation, velocity defect along the wake and the wake thickness. A blower type low speed (open jet) wind tunnel was used in the experimental work. The mean velocity at the test section was (9.3 m/s) and the Reynolds number based on the mean aerodynamic chord and the mean velocity was (0.46x105). The measurements sho
... Show MoreThe aim of the present research is to study different protein fractions in sera of children and adolescent with β –thalassemia major and minor and to compare the results with that of healthy control.One hundred fifty children and adolescents were enrolled in this study,including 50 patients with β- thalassemia major , 50 patients with β- thalassemia minor as pathological control group and another apparently 50 healthy individuals as a control group. The age of all studied groups ranged from (4-18)years.Total protein, albumin and immunoglobulins were estimated in sera of all subjects. A Significant decrease was found in the total protein and albumin&nb
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ABSTRACT: BACKGROUND: Estrogens has traditionally been known as the female hormone, but this idea has been challenged in early 1990’s and an essential physiological role for estrogen in male fertility was identified. Phytoestrogens are naturally occurring non-steroidal plant chemicals that can act like the female hormone estrogen. The herbs ( anise alfalfa and vervain ) chosen in this study contain phytoestrogens. OBJECTIVE: Previous studies demonstrated controversy of the effects of phytoestrogens on the rat testes .Hence, the present investigation was undertaken to investigate the influence of typical dose of herbs containing phytoestrogen on the rat testis. MATERIALS AND METHODS: Twenty-four apparently normal mature male rats we
... Show MoreIsolated Bacteria from the roots of barley were studied; two stages of processes Isolated and screening were applied in order to find the best bacteria to remove kerosene from soil. The active bacteria are isolated for kerosene degradation process. It has been found that Klebsiella pneumoniae sp. have the highest kerosene degradation which is 88.5%. The optimum conditions of kerosene degradation by Klebsiella pneumonia sp. are pH5, 48hr incubation period, 35°C temperature and 10000ppm the best kerosene concentration. The results 10000ppm showed that the maximum kerosene degradation can reach 99.58% after 48 h of incubation. Higher Kerosene degradation which was 99.83% was obtained at pH5. Kerosene degradation was found to be maximum at 3
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Background: Painful elbow joint over the lateral epicondyle especially with resisted wrist extension are common signs of lateral epicondyle tendinopathy, also called tennis elbow. Objective: To evaluate the clinical outcome of local platelet rich plasma (PRP) injection in patients with chronic tennis elbow compared with a steroid (Depomedrol 40 mg) injection. Methods: A total of 88 patients with chronic tennis elbow were treated at Al-Kindy Teaching Hospital and private clinics. All patients had chronic pain for about 24 weeks or more and had failed first line treatment. The patients dividing into two groups, Group A injected with PRP (n = 44), and group B injected with depomedrol 40 mg (n = 44). A good clinical result w
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Background: Opportunistic viral infections make an important threat to renal transplantation recipients (RTRs), and with the use of more intense newly-developed immunosuppressive drugs; the risk of renal allograft loss due to reactivation of these viruses has increased considerably. At the top priority of these viruses lie BK polyomavirus (BKV) and human cytomegalovirus (CMV). Reactivation of these viruses in these chronically immunosuppressed RTRs can lead to renal impairment and subsequently allograft loss, unless early detected and properly treated. Objectives: The study aimed to detect and quantify plasma viral load of BKV and CMV in RTRs using quantitative real time PCR (qRT-PCR), in order to study the prevalence of these two viruses i
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