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.
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
The 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.
This study focused on the expression and regulation of BRCA1 in breast cancer cell lines compared to normal breast. BRCA1 transcript levels were assessed by real time quantitative polymerase chain reaction (RT-qPCR) in the cancer cell lines. Our data show overexpression of BRCA1 mRNA level in all the studied breast cancer cell lines: MCF-7, T47D, MDA-MB-231 and MDA-MB-468 along with Jurkat, leukemia T-lymphocyte, the positive control, relative to normal breast tissue. To investigate whether a positive or negative correlation exists between BRCA1 and the transcription factor E2F6, three different si-RNA specific for E2F6 were used to transfect the normal and cancerous breast cell lines. Interestingly, strong negative relationship was found b
... Show MoreObjective(s): To determine the impact of the Electronic Health Information Systems upon medical, medical backing and administrative business fields in Al-Kindy Teaching Hospital and to identify the relationship between such impact and their demographic characteristics of years of employment, place of work, and education. Methodology: A descriptive analytical design is employed through the period of April 25th 2016 to May 28th 2016. A purposive "non- probability" sample of (50) subject is selected. The sample is comprised of (25) medical and medical backing staff and (25) administrative staff who are all
Objective: to assess the awareness and knowledge of our medical students regarding dose levels of imaging procedures and radiation safety issues, and to conclude how the curriculum of clinical radiology in the college medical program impacts such knowledge.
Subjects and methods: this is a cross-sectional study conducted among 150 medical students in Alkindy College of Medicine between January 2021 to July 2021, regardless of their age or gender. The study included six grades according to the year 2020-2021. A questionnaire consisting of 12 multiple-choice questions was conducted via an online survey using Google Forms. The questions were divided into two parts
... Show MoreThe petroleum industry, which is one of the pillars of the national economy, has the potential to generate vast wealth and employment possibilities. The transportation of petroleum products is complicated and changeable because of the hazards caused by the corrosion consequences. Hazardous chemical leaks caused by natural disasters may harm the environment, resulting in significant economic losses. It significantly threatens the aim for sustainable development. When a result, determining the likelihood of leakage and the potential for environmental harm, it becomes a top priority for decision-makers as they develop maintenance plans. This study aims to provide an in-depth understanding of the risks associated with oil and gas pipeli
... Show MoreArab-Islamic architecture has undergone a change at multiple levels affected by modern technology, so the research sought to address the role of contemporary technologies on a fundamental and fundamental component of architecture, which is the architectural space, what is known as the essence of architecture and its ultimate destination, with a focus on the architectural space in the architecture of the contemporary Arab Islamic mosque, because the mosque’s architecture is so important in Islamic law and the belief of the Muslim person himself, where the mosque is the functional style produced by the Islamic faith and embodied in it, whereas, knowing the levels of influence of contemporary technologies in the architectural spac
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