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.
Crime is one of the most severe challenges facing States, and strives to find preventive measures, reduce its seriousness, and prevent them; due to developments, crimes have increased, and emerging new patterns of crimes, there is an urgent need to prevent crimes and reduce their effects. Modernizing its punitive system and diverting it to correctional rehabilitative justice to redress the prejudice caused by the crime and rehabilitate the convicted person by using alternative measures to short-term imprisonment. This research emphasizes alternative sanctions' value to minimizing short-term imprisonment penalties and their impact on societal security through several goals like, the negative consequences, justifications, and alternatives
... Show MoreAbstract: Lymphoproliferative Disorders (LPDs) are a group of neoplasms affecting various cells within lymphoid system. Each type has different treatment a..70619
It is a moral presumption that includes the object for its sake, and it is called the object for it or the object for its sake, which is the present tense after (lam, ki, fa, willn, and then), and it is not an excuse for the occurrence of the matter (1), and it requires a connection between the two sides of (a cause with a cause) united by a reason for a specific purpose (2). The object has a reason or an excuse, because it is an explanation of what came before it, of the cause. The reason for the occurrence of the action, being the motive for causing the action and the bearer of it (3), indicates that the infinitive is restricted to a special reason. So if I said: (I came to you with the hope of honoring you), then I attributed the coming
... Show MoreThis study was done to evaluate a new technique to determine the presence of methamphetamine in the hair using nano bentonite-based adsorbent as the filler of extraction column. The state of the art of this study was based on the presence of silica in the nano bentonite that was assumed can interact with methamphetamine. The hair used was treated using methanol to extract the presence of methamphetamine, then it was continued by sonicating the hair sample. Qualitative analysis using Marquish reagent was performed to confirm the presence of methamphetamine in the isolate.The hair sample that has been taken in a different period confirmed that this current developing method can be used to analyzed methamphetamine. This m
... Show MoreBackground: Periodontal disease is a chronic bacterial infection that affects the gingiva and bone supporting the teeth. Smoking, which is an important risk factor for periodontitis, induce oxidative stress in the body and cause an imbalance between reactive oxygen species (ROS) and antioxidants, such as superoxide dismutase (SOD). This study aimed to evaluate the influence of smoking on periodontal health status by estimating the levels of salivary SOD level in non-smokers (controls) and light and heavy smokers and to test the correlation between the SOD enzyme level and the clinical periodontal parameters in each group. Materials and Methods: The study sample consisted of 75 male, with age ranged from 35 to 50 years. Clinically, the perio
... Show MoreThis investigation integrates experimental and numerical approaches to study a novel solar air heater aimed at achieving an efficient design for a solar collector suitable for drying applications under the meteorological conditions of Iraq. The importance of this investigation stems from the lack of optimal exploitation of solar energy reaching the solar collector, primarily attributable to elevated thermal losses despite numerous designs employed in such solar systems. Consequently, enhancing the thermal performance of solar collectors, particularly those employed in crop drying applications, stands as a crucial focal point for researchers within this domain. Two identical double-pass solar air heaters were designed and constructed for
... Show MoreThis research seeks through the adoption of two basic variables, where he considered the actuarial experience as an independent variable, while the process of accepting the risk and dimensions related to it is a dependent variable, the research was adopted to present the data achieved by the company during the life insurance business during the adoption of actuarial experience at the beginning of its work where Adoption of the historical method in the analysis of those data to prove the researcher's opinion, through the analysis of data (5 years) for the first period, which extends between (1975-1979), the period during which the company adopted the actuarial experience at the time, also taken data for the same dimensions related to the
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