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.
Each era has advantages in terms of innovation and development in form, technology, style, and design in ceramic vessels, both at the level of functional and aesthetic performance, so this study aimed to demonstrate the importance of geometrical foundations in the design structure of contemporary ceramic vessels, and also to reveal the constructive skills in The structure of the ceramic figure.
The researchers used the descriptive analytical approach to suit the nature of the study, and they described and analyzed the ceramic works in terms of geometric shape systems, elements and foundations of design in construction, formal diversity in the general design of ceramic vessels, and references and sources of artwork. In addition to th
The study included three topics, the definition of the personality of Imam al-Bazazi, his scientific biography, his elders, his writings, his students and his death, selected issues of his weightiness related to purity, and the Imam al-Bazazi is Muhammad ibn Muhammad ibnShihabibn Yusuf, known in al-Kardari al-Hanafi al-Balzazi. The other doctrines, the author relied in his book on the sources of the previous scholars of the Hanafis, and make them the basis in his book, the author did not adopt the definitions of language and terminology, and rarely mention the evidence Shariah adopted by scientists in their opinions, and limited to mention only opinions, In front of the first issue spotlessly water user, and the second issue that sleep l
... Show MoreThe practical picture was clear in the statement of the foundations of moderation and its impact on the future of the nation, and in it a statement of the foundations on which moderation is based as the foundations for building moderation, the goals that moderation seeks and the desired results as a result of the applications of moderation. It was about the positive impact of moderation on the future of the nation in maintaining social balances such as economic, cultural and political balance and preserving freedoms.
The floating ice shelves around Antarctica, which buttress ice streams from the continent and slow their discharge into the sea, are thinning at faster rates. Paolo
Periodontitis is a persistent bacterial-causing disease which damages the supporting periodontium of the teeth. The complexity of supporting tissue structure makes the regeneration a challenge for periodontists. Early investigations were focused on discovering therapeutic substitutes that are biocompatible, simple to prepare and economic. This might cause a local release of growth factors that accelerate the healing process of the soft and hard tissue. Recently, platelet-rich fibrin (PRF) has received a wide attention as a biocompatible regenerative material in both dental and medical fields. PRF is a natural fibrin-derived biomaterial, and it is easy to obtain. It can be gotten from individual blood without the use of any external anticoag
... Show MoreIn this review, previous studies on the synthesis and characterization of the metal Complexes with paracetamol by elemental analysis, thermal analysis, (IR, NMR and UV-Vis (spectroscopy and conductivity. In reviewing these studies, the authors found that paracetamol can be coordinated through the pair of electrons on the hydroxyl O-atom, carbonyl O-atom, and N-atom of the amide group. If the paracetamol was a monodentate ligand, it will be coordinated by one of the following atoms O-hydroxyl, O-carbonyl or N-amide. But if the paracetamol was bidentate, it is coordinated by atoms (O-carbonyl and N-amide), (O-hydroxyl and N-amide) or (O-carbonyl and O-hydroxyl). The authors also found that free paracetamol and its complexes have antimicrobial
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