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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A novel planar type antenna printed on a high permittivity Rogers’ substrate is proposed for early stage microwave breast cancer detection. The design is based on a p-shaped wide-slot structure with microstrip feeding circuit to eliminate losses of transmission. The design parameters are optimized resulting in a good reflection coefficient at −10 dB from 4.5 to 10.9 GHz. Imaging result using inhomogeneous breast phantom indicates that the proposed antenna is capable of detecting a 5 mm size cancerous tumor embedded inside the fibroglandular region with dielectric contrast between the target and the surrounding materials ranging from 1.7 : 1 to 3.6 : 1.
paid recent developments in the information and communications technology and the accompanying developments in the global market to pay particular accounting information users to demand more sophistication in terms of corporate financial reporting systems, which led to the emergence of a new type of reporting (financial reporting in real time). where is the information and communications technology mainstay Nations for the development and progress, thanks to the development of technology that have made the transmission of information easily conducted and high speed to all who need it, communication is instantaneous and the flow of information via the internet dramatically exceeded the border temporal and spatial anywhere in the w
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Background: University dental students perceived a higher level of stress prior to the final exam associated with raised salivary cortisol levels which could be considered as a useful noninvasive biomarker for measuring acute stress. Using a Helkimo anamnestic and clinical dysfunction scoring for temporomandibular disorders can give a better insight about the association of this marker and temporomandibular joint disorders. The aim of this study was to evaluation level of salivary cortisol in stressor students with temporomandibular disorder and the relation between this marker in relation to temporomandibular disorder severity. This might give a better understanding to the role of psychological stress as an etiological factor for developin
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This research was conducted to measure the safety of heat stable enterotoxin a (STa) produced by enterotoxigenic Escherichia coli, through studying its toxic effect on mice since it showed a promising effect in reducing the proliferation of colorectal cancer cells. The cytogenetic effect was determined after giving five different doses (100, 200, 400, 800 and 1600)μg/Kg in comparison with negative (phosphate buffer saline / PBS) and positive (mitomycin C/ MMC, at doses of 2 and 5μg/Kg) controls on mouse bone marrow cells by employing the following parameters: mitotic index, chromosomal aberrations and micronucleus, also, the serum level of liver functional enzymes (GOT, GPT, ALP) was recorded. In addition, lethal dose 50 (LD 50) with cert
... Show MoreOne of the main parts in hydraulic system is directional control valve, which is needed in order to operate hydraulic actuator. Practically, a conventional directional control valve has complex construction and moving parts, such as spool. Alternatively, a proposed Magneto-rheological (MR) directional control valve can offer a better solution without any moving parts by means of MR fluid. MR fluid consists of stable suspension of micro-sized magnetic particles dispersed in carrier medium like hydrocarbon oil. The main objectives of this present research are to design a MR directional control valve using MR fluid, to analyse its magnetic circuit using FEMM software, and to study and simulate the performance of this valve. In this research, a
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The Reasons behind the decadence of the studies concerning the evening school in Salah al Deen A field study