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.
Background: Dysfunction of sinoatrial node is a set of abnormal rhythms which are resulted from the sinoatrial node malfunctionof the sinus node, the chief natural cardiac pacemaker. The common, and occasionally, the single method for treatment of heart arrhythmias wasimplantation of pacemaker, which reduce symptoms exactly occurs after implantation. Aim: To detect the association between red cell width diameter (RDW) and some cardiac electrophysiology parameters in sinus node dysfunction in Iraqi patients such as SNRT and AH. Methods: A cross sectional study, was conducted on 59 patient ranging between 20-50 years old and involving 35 female and 24 male patients, suffering from an unexplained symptoms of sinoatrial node dysfunction (SND).
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The study aimed to identify what (isis) (Daesh) have been touched in the opening article of Al-Nabaa newspaper This objective is organized for asset of sub-targets it is the knowledge of media discourse and for those who are directed and methods of employing the strong content debt organization and we used the survay method to monitor and understand the content of opening anticale and the researcher took the numbers of the newspaper for years 2015-2018 consist of 157 The results of this study are :
* Use religious texts from (Holly qoran) (Abbreission of the prophetic) Remove from its context and empby them in justifying in what use of vio |
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Abstract That the child is aged 7 years, surrounded by information, knowledge and skillsvaried, which constitute the raw material of experience teaching and is in the rule of inputlearning, if received by the student of these data are positive, these data require research and audit, the style becomes more positive, effective, and then becomes the explorer, butnot done exploration efficiency without the visual, auditory and sensory owned by thechildren. So study aimed to identify the values of the optical track and explore mathematical and find the relationship between them. And use the descriptive approach in a manner the linkon the children of the first year of primary school age (6-7) years in my school Waziriya and Karkh, during the peri
... Show MoreThe Ottomans ruled Turkey for nearly six centuries, during which the Ottoman Empire passed through varying periods in terms of strength, influence, and the area of land they ruled. In the last decade of its rule, the Ottoman Empire was severely weakened in all political, military, administrative and economic aspects. In addition to the internal strife that was stirred up by the leaders of the Association (Union and Progression), that organization that led the coup movement against the Ottoman Empire later.
After the abolition of the Sultanate and the proclamation of the Turkish Republic, the social fabric in Turkey changed, and many customs and traditions alien to it emerged to society. One of the thing
... Show MoreBackground The traditional management of appendicular mass is an initial conservative treatment followed by interval appendectomy. Recently interval appendicectomy has been questioned.
Objective: The purpose of this study was to clarify the need and the role of interval appendicectomy after successful initial conservative treatment.
Method: This is a prospective study conducted in a major hospital in Basra from April 2006 to Septemper2010, included 65 patients with appendicular mass which subsequently proved postinflammmatory (phlegmonous) changes of the appendix were treated conservatively.
Results: Routine interval appendicectomy was not performed and needed after successful treatment in the majority of the patients (84.6%). F
The application of physiological oxygen (physoxia) concentrations is becoming increasingly commonplace within a mammalian stem cell culture. Human mesenchymal stem cells (hMSCs) attract widespread interest for clinical application due to their unique immunomodulatory, multi-lineage potential, and regenerative capacities. Descriptions of the impact of physoxia on global DNA methylation patterns in hMSCs and the activity of enzymatic machinery responsible for its regulation remain limited. Human bone marrow-derived mesenchymal stem cells (BM-hMSCs, passage 1) isolated in reduced oxygen conditions displayed an upregulation of SOX2 in reduced oxygen conditions vs. air oxygen (21% O2, AO), while no change was noted for either OCT-4 or NA
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Rheumatoid arthritis is a chronic systemic inflammatory disease. Inflammation leads to joint damage and increases the risk of cardiovascular diseases. Neutrophil lymphocyte ratio (NLR) is a measure of inflammation in many diseases. Therefore, we aimed to evaluate the usefulness of NLR to detect inflammation in RA, and its correlation to RA disease activity indices and some hematological parameters. A cross-sectional study involving 24 patients with active rheumatoid arthritis (RA) who are using MTX participated in this study. All patients were clinically evaluated using disease activity score of 28 joints (DAS28) and simplified disease activity index (SDAI), whereas functional disability was assessed by health assessment questionnaire di
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Singled current study on the subject of shorthand in structure designs logos (Iraqi sports clubs model), as the current study Tdmt four chapters, was in the first chapter defines the research problem and its significance, as well as the aim of the research in the know shorthand formal in structure designs logos (Iraqi sports clubs model ), and identifies Find time limits: - slogans Iraqi sports clubs for the years (1956 - 1970), because it represented the years to include designs slogans official Iraqi sports clubs that have been elected in this period for the purpose of examining the reality of the design in the current search. And it represented the spatial limits: - the Republic of Iraq - Iraqi slogans designs sports
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