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.
An investigation of the quadrupole deformation of Kr, Sr, Zr, and Mo isotopes has been conducted using the HFB method and SLy4 Skyrme parameterization. The primary role of occupancy of single particle state 2d5/2 in the existence of the weakly bound structure around N=50 is probed. Shell gaps are performed using a few other calculations for the doubly magic number 100Sn using different Skyrme parameterizations. We explore the interplays among neutron pairing strength and neutron density profile in two dimensions, along with the deformations of 100Sn.
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The nanostructured MnO2 /carbon fiber (CF) composite electrode was prepared using the anodic electrodeposition process. The crystal structure and morphology of MnO2 particles were determined with X-ray diffraction and field-emission scanning electron microscopy. The electrosorptive properties of the prepared electrode were investigated in the removal of cadmium ions from aqueous solution, and the effect of pH, cell voltage, and ionic strength was optimized and modeled using the response surface methodology combined with Box–Behnken design. The results confirm that the optimum conditions to remove Cd(II) ions were: pH of 6.03, a voltage of 2.77 V, and NaCl concentration of 3 g/L. The experimental results showed a good fit for the Freundli
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The research objectives, to build a measure of the level of tactical performance of volleyball players applying for the Iraqi Premier League for the 2018-2019 season. The nature of the research problem, then the researchers determined the research sample in the deliberate manner of the players of the Iraqi clubs for the Premier League (B, A). The researchers adopted the entire community as a sample for the research, and the number (156) players distributed over (13) clubs and divided the sample into (12)players an exploratory experiment player representing (the police club) and (100) player representing the construction sample and after a maximum period of two months has passed since applying the scale to the construction sample the researc
... Show MoreVerbal Antonyms: A research in the relationship in meaning Between the words in Arabic language
تناولنا في هذه الدراسة التأكيد على تطوير المناهج الدراسية بأتجاه تنمية قيم التسامح والتعايش السلمي ، لان ثقافة التسامح باتت من الضرورات الملحة التي يفرضها الواقع الراهن لمواجهة العنف المجتمعي ، مما يوجب الحرص على ترسيخ القيم الانسانية ، لان التسامح من الصفات التي تحبها النفوس وتنجذب اليها القلوب .
والقيم الاخلاقية والسلوكية كالتسامح وغيرها ، من الامور الرئيسية لعمليتي التربية والتعليم في المدارس وال
... Show MoreWitch stories are part of American popular culture, and this culture is extremely influenced by a continuing reliance on its past. The modern obsession of Americans with witches, whether real or metaphorical, is related to politics especially when it came to issues of gender politics. This article exposes a modern image of the female character seen from a male author point of view. John Updike, influenced by the changes that happened to women within second wave of feminism, attempted to write The Witches of Eastwick (1984). Actually, he presented women who did have a sort of careers. His witches are professional active and dynamic. What do witches stand for in American Culture? Why did Updike choose to write
... Show MoreBackground : Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy of upper extremities and Open carpal tunnel release is the most frequent surgical procedure and the gold standard for cases that do not respond to conservative treatment. Aims :This study is used to evaluate the functional outcome of limited palmar mini-incision of carpal tunnel release. This study aims to determine the safety and symptomatic and functional efficacy of median nerve decompression with limited incision in carpal tunnel syndrome surgery. Patients and methods:Carpal tunnel release with a 1.5-2 cm limited palmar incision was performed on 20 patients. Patients were evaluated initially at one month after treatment according to symptom severity
... Show MoreThe densities and visconsities of solutions of poly(vinyl alcohol)(PVA) molccuar weight (14)kg.mol-1in water up to 0.035%mol.kg-1
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