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.
Low 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. Key words: obesity, low back pain,
Many patients with advanced type 2 diabetes mellitus (T2DM) and all patients with T1DM require insulin to keep blood glucose levels in the target range. The most common route of insulin administration is subcutaneous insulin injections. There are many ways to deliver insulin subcutaneously, such as vials and syringes, insulin pens, and insulin pumps. Though subcutaneous insulin delivery is the standard route of insulin administration, it is associated with injection pain, needle phobia, lipodystrophy, noncompliance, and peripheral hyperinsulinemia. Therefore, the need exists to deliver insulin in a minimally invasive or noninvasive way and in the most physiological way. Inhaled insulin was the first approved noninvasive and alternative way
... Show MoreBackground: The transcriptional control of various cell types, especially in the development or functioning of immune system cells involved in either promoting or inhibiting the immune response against cancer, is significantly influenced by DNA or RNA methylation. Multifaceted interconnections exist between immunological or cancer cell populations in the tumor's microenvironment (TME). TME alters the fluctuating DNA (as well as RNA) methylation sequences in these immunological cells to change their development into pro- or anti-cancer cell categories (such as T cells, which are regulatory, for instance). Objective: This review highlights the impact of DNA and RNA methylation on myeloid and lymphoid cells, unraveling their intricate
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A recurrent condition that affects up to 10% of people worldwide is gastric ulceration illness. The existence of gastric juice pH with the lowering of mucous defences is prerequisites for the development of chronic ulcers. The main variables affecting the mucosa susceptibility to damage include Helicobacter pylori (H. pylori) infections or non-steroidal anti-inflammatory medicines (NSAIDs). Proton pump inhibitors (PPIs) including histamine-2 (H2) receptor inhibitors, two common therapies for peptic ulcers, have been linked to side impacts, recurrence or a variety of pharmacological combinations. Conversely, therapeutic herbs or the chemicals they contain may be used to cure or eliminate a wide range of illnesses. Therefore, prominent pharma
... Show Moreالخلفية: العقدية المقيحة المعروفة أيضًا باسم ""(GAS) هي احدى مسببات الأمراض ذات الأهمية الصحية العامة، حيث تصيب 18.1 مليون شخص في جميع أنحاء العالم وتقتل 500000 شخص كل عام. الهدف: حددت هذه المراجعة المقالات المنشورة حول عوامل الخطر واستراتيجيات الوقاية والسيطرة لأمراض المكورات العقدية. المواد والأساليب: تم إجراء بحث منهجي لتحديد الأوراق المنشورة على قواعد البيانات الإلكترونية Web of Science و PubMed و Scopus و Google Scholar في مح
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Mannich base is a versatile compound that can be easily modified to introduce different functional groups, allowing for the creation diverse selection of items with varying features. Additionally, the Mannich reaction is a valuable tool in organic synthesis, due to the fact it provides an effortless and efficient approach for synthesizing C-N bonds. Overall, The Mannich base and even its derivatives are essential in many aspects of chemistry and its complexes are in the pharmaceutical industry. Studies have revealed that it shows good anti-cancer, anti-mycobacterial, remarkable anti-HIV, anti-tubercular, anti-convulsant, anti-fungal, antiviral, antitumor, cytotoxic activities and in industrial applications such as in the creation of polymer
... Show MorePharmaceutical care is a patient-centered, outcomes oriented practice that requires the pharmacist to work in concert with the patient and the patient’s other healthcare providers to promote health, to prevent disease, and to assess, monitor, initiate, and modify medication use to assure that drug therapy regimens are safe and effective. In addition, the presence of clinical pharmacists has led to a higher quality of patient education and provision of complete detailed information for patients. In developed countries Pharm D has become the professional degree for practice of Pharmacy. The graduates will be enrolled in a pharmacy residency program; admission to the residency programs is available to Pharm D graduates of an accredit
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As they include both nucleophilic and electrophilic moieties on the same skeleton, enaminones are an important subclass of chemical compounds that contain conjugated NC=CC=O fragments. These active sites aid in the production of organic molecules containing linear or cyclic heteroatoms. Enaminones and the chemica1 compounds produced from them are both biologically active against the most dangerous bacteria. As a result, they have been utilized as starting materials for the synthesis of anti-inf1ammatory, antibacteria1, anticonvulsant, anticancer, anti-urease, anti-malaria1, optically luminescent, corrosion inhibition, and antitumor agents. Their synthesis has usually a terrific deal of interest and a plethora of synthetic paths have been na
... Show MorePolyacrylonitrile nanofiber (PANFS), a well-known polymers, has been extensively employed in the manufacturing of carbon nanofibers (CNFS), which have recently gained substantial attention due to their excellent features, such as spinnability, environmental friendliness, and commercial feasibility. Because of their high carbon yield and versatility in tailoring the final CNFS structure, In addition to the simple formation of ladder structures through nitrile polymerization to yield stable products, CNFS and PAN have been the focus of extensive research as potential production precursors. For instance, the development of biomedical and high-performance composites has now become achievable. PAN homopolymer or PAN-based precursor copolymer can
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