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.
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Introduction: Carrier-based gutta-percha is an effective method of root canal obturation creating a 3-dimensional filling; however, retrieval of the plastic carrier is relatively difficult, particularly with smaller sizes. The purpose of this study was to develop composite carriers consisting of polyethylene (PE), hydroxyapatite (HA), and strontium oxide (SrO) for carrier-based root canal obturation. Methods: Composite fibers of HA, PE, and SrO were fabricated in the shape of a carrier for delivering gutta-percha (GP) using a melt-extrusion process. The fibers were characterized using infrared spectroscopy and the thermal properties determined using differential scanning calorimetry. The elastic modulus and tensile strength tests were dete
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Background: Impression materials, impression trays, and poured stone cast have been said to be the main source of cross infection between patients and dentists. However, it was observed that disinfection of the impression is not performed systematically in routine dental practice. Disinfection of alginates either by immersion or spray technique was found to cause dimensional inaccuracies, although with proper disinfection of alginates there were small dimensional changes. A variety of fluoride releasing products designed for topical use is currently available. Following their use, varied amount of fluoride is systemically absorbed depending on the fluoride concentration and the manner of its use. The objective of this study was to evaluate
... Show MoreABSTRACTBackground: Concerns about hepatitis A infections is increasing worldwide specially after improving economic and sanitary conditions in many countries making older age groups who escape infection on early life vulnerable to infection.Objectives: The objectives were to estimate the frequency of hepatitis A among children consulting Al Alwyia pediatric Teaching Hospital during the year 2013 and to study some demographic characteristics of the disease.Methods: This cross - sectional hospital -based study wasconducted during 2013-2014 and include pediatric patients(43525 patients) who consult Al Alwyia pediatric hospitalduring that time. The outcome is total IgM antibodies tohepatitis A virus detected using Enzyme Linked FluorescentA
... Show MoreThis article deals with the study of theories about verbal periphrasis as a grammatical construction; the aim of this point it offers good and valid guidelines to improve the linguistic description. The interest in the subject comes from its importance in the process of language teaching for the students of Spanish and to clarify this type of curriculum of this research we analyzed a literary text. From "Zurita"
Atmospheric transmission is disturbed by scintillation, where scintillation caused more beam divergence. In this work target image spot radius was calculated in presence of atmospheric scintillation. The calculation depend on few relevant equation based on atmospheric parameter (for Middle East), tracking range, expansion ratio of applied beam expander's, receiving unit lens F-number, and the laser wavelength besides photodetector parameter. At maximum target range Rmax =20 km, target image radius is at its maximum Rs=0.4 mm. As the range decreases spot radius decreases too, until the range reaches limit (4 km) at which target image spot radius at its minimum value (0.22 mm). Then as the range decreases, spot radius increases due to geom
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