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 expression is a prominent feature of the Arabic language, but it is one of the characteristics that are inseparable from it. The expressive aspects of each other.
The issue of Arab differences and their impact on the divergence of meaning is one of the issues that have preoccupied the minds of the Arabic language owners and their views went to various doctrines. Introduction: (Whenever I finished a question concluded with a verse related to any download, and followed by the need for expressing, interpretation and interpretation) I found him in some of the Aarabip more than the face of some of the vocabulary raised and erected and a jar, when the verses of the Koran, resulting in a research lies between Grammar and the Koran under
Otitis media with effusion (OME) is the long-term deposition of mucus in the middle ear cleft. It is the leading cause of childhood hearing loss and a common childhood infection. It can impair communication and life quality. OME's direct and indirect costs are also crucial. Improving OME care is crucial. This study examines intranasal mometasone's efficacy in treating otitis media with effusion. A clinical trial study was conducted during a period from January 2021 to June 2022. It included 80 patients suffering from otitis media with effusion bilaterally (160 ears) who had an intact tympanic membrane and tympanometry type B. These patients were included only if they had a hearing change or loss noted by the parents or by the patien
... Show MoreBackground: Hemorrhoids are one of the most
common surgical conditions .Conventional
haemorrhoidectomy was the traditional operation for
the treatment of hemorrhoids. Other modalities of
treatment had been used as an alternative operations
including CO2 laser haemorrhoidectomy.
Objectives: To determine the outcome of treatment
of hemorrhoids by using CO2 laser
haemorrhoidectomy and its advantages over
conventional surgery
Methods: This is a retrospective comparative
interventional study of 1024 case of third degree
haemorhoids selected out of 1300 case of
hemorrhoids of different degrees, admitted to
ALKINDY, ALYERMOUK teaching hospitals and
ABD ALMAGEED private hospital, from May 1998
to J
Background: Major depressive disorder (MDD) is mental disorder characterized by an all-encompassing low mood accompanied by low self-esteem, and by loss of interest or pleasure in normally enjoyable activities. The aims of the study: were to determine the prevalence of oral manifestation among patients with major depressive disorder receiving antidepressant drugs, and detect alkaline phosphatase (ALP), Total Salivary proteins (TSP), and Interleukin-6 (IL-6) in relation to MDD patients under treatment and to compare with healthy controls. Materials and method: (50) MDD patients; between the ages of 20 years and 60 years.The depression patients are divided into (25) patients under treatment with fluoxetine (Prozac), and (25) patients under tr
... Show MoreDuring pregnancy, high blood pressure disorder is the most common medical complication in pregnancy. It is the foremost cause of maternal mortality and perinatal diseases. Vascular endothelial growth factor (VEGF) affects the growth of vascular endothelial cells, existence, and multiplying, which are known to be expressed in the human placenta. This study aimed to identify the expression VEGF in the placenta of hypertension and normotensive women. In this study, a cross-sectional study from november 2019 to February 2020. A total of 100 placentae involved 50 hypertensive cases and 50 normotensive groups were assessed. VEGF-A expression in two placentas groups was evaluated by immunohistochemistry techniques. Strong and moderate VEGF
... Show MoreThe aim of this research to show the role of some enzymes in pathological mechanism of rheumatoid arthritis (RA) disease. Sixty patients with RA and matched number of apparently healthy volunteers were included in the study. Spectrophotometric methods were used to determine Peroxy nitrite (ONOO), Nitric oxide (NO), Nitric oxide synthase activity (NOS) cycloxygenase-2 activity (COX-2), glutathione peroxidase (GPX) activity and superoxide dismutase (SOD) activity in serum of both groups. Colorimetric assay kits were used to determine Iron. Rheumatoid factor (RF) was determined using Imuno-Latex kit. ONOO, NO levels, and NOS activity were significantly higher in the patients compared to the control group. Conversely, Iron level, SOD
... Show MoreThe study aims to identify the symptoms of PTSD among displaced Yazidi women according to age, marital status, educational level, and type of status (displaced or survivor). The study also seeks to identify the effect of the relaxation program on reducing PTSD among displaced Yazidi women. The research sample included (60) Yazidis for the statistical analysis sample and (5) for the experimental sample in the Dohuk governorate. For achieving the research objectives, a scale was used from the PTSD Checklist for DSM-5 (PCL-5), as well as a relaxation program was prepared. The researchers reached the following results that there is an average level of PTSD symptoms among displaced Yazidi women, there are no statistically significant differen
... Show MoreThe investment however "was its description and meaning, it remains a resident" in the composition of capital assets located in the forefront of the creation of productive assets, and this means that the investment in the productive sectors is a priority in achieving capital accumulation, on any other investment that takes place with the stages of advanced development of formation , not forgetting "to humans and investment humans as head of real money product, the source of the economic surplus and accumulation, and the source of producing values, and if human labor was the source of value, and the human was the source of work, therefore humanitarian work on different levels and skills presents capital", so the investment in huma
... Show MoreToday we are witnessing huge scientific and technical progress so we need more skills and methods of thinking that needs to be acquired by the teacher, as the importance of computers in education there are many teachers suffering of the difficulty in teaching for pupils . researchers tried to find a good suitable way with the technological interests for now which represent by computer design software and the introduction of enrichment activities in the curriculum because it is one of a contemporary trends for the development of the Arabic language with various levels of education and knowing if this program has negative or positive impact.
So 
... Show MoreMT Suhail, SA Hussein, MN Abdulhussein, WQ Abdaullateef, M khairallah Aid…, Migration Letters, 2024